Epileptic Seizures: Signs to Help You Recognize One

An epileptic seizure is a sudden, temporary disruption in the brain’s normal electrical activity, one that can manifest in many different ways, from involuntary movements and loss of consciousness to unusual sensory experiences and abrupt changes in behavior.

Waking up to find out someone witnessed you convulsing, or noticing recurring episodes of confusion, blankness, or uncontrolled movements yourself, naturally raises the question: could this be a seizure? This guide is here to help you navigate that uncertainty, identify the warning signs that matter, and understand when and how to seek the right medical care.

Signs That May Be Associated with an Epileptic Seizure

Not every fainting spell, muscle jerk, or moment of “zoning out” means a seizure occurred. This guide is designed to help you put your symptoms in context, identify signs that warrant medical attention, and determine the most appropriate next step, whether that’s monitoring and recording what happened, scheduling a specialist evaluation, or going to the emergency room if any red flags appear.

Sudden fainting.

Many things can cause fainting, but think of a seizure if, afterward, you were very confused, had no memory of the event, or had characteristic injuries (bumps, tongue bite). If it was your first episode, a medical evaluation is bly recommended.

Uncontrolled body jerking.

A seizure may present as jerking and/or muscle rigidity. If there were witnesses, gather details: how long it lasted, whether it started on one side of the body, whether there was stiffness beforehand, and how your recovery went. Seek priority medical attention and bring this information to guide evaluation.

Body spasms while sleeping.

Not all spasms that occur during sleep point to epilepsy. The signs that warrant closer attention are waking up confused or disoriented, noticing significant muscle aches or unexplained injuries upon waking, or having someone witness a clear episode overnight. Should the spasms repeat, tracking their duration and context can provide valuable information for a medical evaluation.

Brief blank spells with no memory.

Some seizures involve no convulsions at all, you stare blankly, are unresponsive for a few seconds, then continue as if nothing happened. If this is repetitive or others notice you “checking out,” this warrants a medical evaluation.

Sudden mental gaps.

These stand out when they are abrupt, brief, repetitive, and followed by no memory of what just happened. Record when they occur, how long they last, and what you were doing at the time.

Waking up with a bitten tongue.

Finding a tongue bite upon waking does not confirm epilepsy, but it is a clinically relevant finding, especially when accompanied by amnesia, unexplained injuries, or waking up on the floor.

Why Do Epileptic Seizures Happen?

A seizure occurs when a group of neurons temporarily “misfires,” generating an abnormal electrical discharge. This can produce anything from a brief lapse in awareness (absence seizure) to full convulsions. To put the scale in perspective: the WHO estimates that around 50 million people worldwide live with epilepsy, and the Pan American Health Organization (PAHO) estimates approximately 5 million cases across the Americas. In Mexico, the Secretaría de Salud has reported an estimated figure of approximately 2 million people living with epilepsy.

What to Do If You Think You Had a Seizure

While awaiting evaluation, prioritize safety: avoid driving, heights, swimming alone, or bathing in a tub. Get enough sleep and avoid alcohol. If it happens again, have someone time it and apply basic first aid. To decide between scheduling a medical evaluation or going to the emergency room, work through the following questions:

1. Was this your first episode?

If this has never happened before, a prompt medical evaluation is warranted, even if you feel fine now. If there was a fall, a head injury, or you are unsure how it happened, consider going to the emergency room.

2. How long did it last? (Time it if it happens again)

• More than 5 minutes → go to the emergency room.
• One seizure immediately followed by another without recovering → go to the emergency room.

3. Are there any warning signs right now?

Go to the emergency room if you experience: difficulty breathing, blue-tinged skin, a significant injury, bleeding, severe pain, persistent vomiting, confusion that is not clearing, or failure to return to your normal state.

4. Did it happen in a high-risk situation?

If it occurred while driving, on the street, at a height, or in water (pool or shower), and involved near-drowning, go to the emergency room.

5. Are you pregnant or do you have a medical condition that increases risk?

Pregnancy, diabetes, anticoagulant use, heart disease, or a recent significant head injury → go to the emergency room.

6. If it has passed and you are stable, what is the next step?

Schedule an evaluation at the Neurology Center or Epilepsy Clinic to review the episode, determine whether it was a seizure, and, if applicable, order the necessary studies, such as an EEG.

What Happens After a Seizure?

It is normal to feel drowsy, have a headache, or feel confused after a convulsion. If you do not return to your normal state, have difficulty breathing, or sustained significant injuries during the episode, consider going to the emergency room.

What to do after a convulsion:

Rest, check for injuries, and drink fluids only once you are fully alert. If it was your first episode, schedule a medical evaluation soon, even if you feel like you’ve fully recovered.

What to Do During an Epileptic Seizure

1. Get to safety immediately: If you are driving, pull over to a safe location immediately, activate your hazard lights, and bring the vehicle to a complete stop. Once out of the car, distance yourself from any potential hazards, such as stairs, heights, traffic, fire, open flames, kitchen equipment, sharp objects, glass, and bodies of water, such as showers or pools.
2. Get down to the floor and position yourself safely: If possible, lie on your side on a soft surface (carpet or a low bed) and cushion your head with something soft (a jacket or pillow). This reduces the risk of injury and helps keep your airway clear.
3. Remove anything tight around your neck: ties, scarves, or snug collars.
4. Alert someone as soon as possible: Say out loud: “I think I’m about to have a seizure, please stay with me.” If you are alone, quickly call or text your location to someone. Keeping your phone with you at all times, even at home, is one of the recommended safety measures.
5. Record the seizure: If you are alone, try to start the stopwatch on your phone before the seizure begins, or record a video if possible. The duration and context are vital for determining whether you are dealing with an emergency or a priority medical appointment.
6. Activate your care plan if you already have a diagnosis: If your neurologist has given you an action plan and/or prescribed a rescue medication, follow it exactly as prescribed, do not improvise with dosing.

Focus on breathing slowly and allow the seizure to pass. If you typically lose consciousness, there may be little you can do during the episode itself, which is why what you do before matters most: getting to the floor, removing hazards, and positioning yourself on your side if you can.

Information to Record for Your Doctor

The following data is vital for your medical team to understand what happened. Try to capture it on video if you are alone, or ask someone nearby to document it:

• Time of onset, duration, how it began, movements observed, skin color changes, breathing pattern
• Injuries sustained: tongue bite, loss of bladder or bowel control, post-episode confusion
• Possible triggers: sleep deprivation, alcohol use, stress, missed medications

What NOT to Do During an Epileptic Seizure

• Do not try to hold yourself still or restrain your movements
• Do not put any object in your mouth to prevent biting
• Do not eat, drink, or take medication during the episode
• Do not force yourself to stand up when you first regain consciousness

Once you regain awareness, contact emergency services if any of the 5 conditions listed at the beginning of this article apply, or schedule a priority evaluation with your physician for follow-up.

Studies That May Be Ordered After a Seizure

EEG (Electroencephalogram)

An EEG records the brain’s electrical activity using electrodes placed on the scalp. This study can support the treating physician’s diagnosis and help classify the type of seizure when interpreted by a specialist.

Imaging (CT / MRI) — When Clinically Necessary.

When a first seizure occurs under certain circumstances, or when red flags suggest a more serious underlying cause, imaging may be part of the workup. MRI offers exceptional detail of brain structures using magnetic fields, while CT provides fast, reliable structural images using X-rays and computer reconstruction.

Where to Seek Care in Mexico City: Emergency Room vs. Clinic

Emergency Room (if you meet any of the criteria listed above).

If any of the 5 conditions mentioned at the beginning of this article apply (duration >5 minutes, difficulty breathing, injury, repeated seizures, or first episode), going to the emergency room is the most appropriate decision.

Specialized Follow-Up Care.

If you are stable, schedule an evaluation at the Neurology Center at ABC Medical Center, where a multidisciplinary team of highly trained specialists is available to address your case comprehensively.

Other Frequently Asked Questions About Epileptic Seizures

What are epileptic seizures?

Epileptic seizures are brief episodes caused by abnormal electrical activity in the brain. They may be convulsive (involving rigidity and jerking) or non-convulsive (involving disconnection, a blank stare, or automatic behaviors).

How do I know if it was a seizure or a fainting spell?

Tongue biting, head turning, twisting movements, incontinence, and post-event confusion or amnesia suggest a seizure. If instead you experienced dizziness, tunnel vision, nausea, palpitations, or chest pain before the event, it may have been a syncopal (fainting) episode. When in doubt, consult your doctor to rule out any underlying condition.

What triggers an epileptic seizure?

There may be underlying causes (such as genetics, brain injury, or infection) as well as situational triggers that provoke seizures in susceptible individuals, including sleep deprivation, stress, alcohol or drug use, missed medications, flashing lights, or hormonal changes.

Does having a seizure mean I have epilepsy?

Not necessarily. A seizure can have many causes. Epilepsy is generally defined as a condition characterized by recurrent unprovoked seizures, typically two or more.

Fuentes:

• PAHO
• Gob