Higher-riskArticle link

Understanding Seizure Types and Symptoms: A Guide for Caregivers

Seizures can be frightening, but knowing what to look for and how to respond can help you stay calm and keep your loved one safe. Seizures happen when there is a sudden burst of electrical activity in the brain, and they can take many forms, from a brief staring spell to full-body convulsions. The good news is that most seizures are brief and manageable, and with the right information, you can recognize the signs and take helpful action. This guide walks you through the different types of seizures, their symptoms, and concrete steps you can take to support your person.

Key points

  • Seizures can look very different: from a brief staring spell to full-body convulsions. Always note the time and symptoms.
  • Focal seizures start in one part of the brain and may or may not affect awareness. Generalized seizures affect both sides of the brain.
  • Auras are warning signs that can include a strange smell, taste, fear, or déjà vu. They can help you prepare.
  • Never put anything in the person's mouth during a seizure. Do not restrain them. Protect their head and clear the area.
  • After the seizure, stay calm, speak reassuringly, and help them rest. Call 911 if the seizure lasts more than 5 minutes or if it is their first seizure.
  • Keep a log of seizures and share it with the doctor. This helps with diagnosis and treatment.

What is a seizure and why does it happen?

A seizure is a sudden, uncontrolled electrical disturbance in the brain. Because the brain controls everything we do, seizures can affect movement, sensation, awareness, behavior, and emotions. They can look very different from one person to the next. Some people with epilepsy have the same type of seizure each time, while others may experience more than one type. It is important to know that having a single seizure does not mean a person has epilepsy. Epilepsy is usually diagnosed only after a person has had at least two unprovoked seizures at least 24 hours apart. Many people with epilepsy can manage their seizures with medication or, in some cases, surgery. Some children may even outgrow the condition.

The two main categories: focal and generalized seizures

Seizures are classified as either focal or generalized, based on where the abnormal electrical activity starts in the brain. Focal seizures begin in just one area of the brain. They can happen in two ways: without loss of awareness or with impaired awareness. In a focal seizure without loss of awareness, the person remains conscious but may have unusual feelings or sensations, such as a strange smell, taste, or sound, or they might see flashing lights. They may also feel dizzy, tingly, or have a sudden emotional change like fear or déjà vu. In a focal seizure with impaired awareness, the person may seem confused, stare blankly, or perform repetitive movements like lip smacking or hand rubbing. Generalized seizures involve both sides of the brain from the start. The most dramatic type is the generalized tonic-clonic seizure, where the person loses consciousness, their body stiffens, and then their arms and legs jerk rhythmically. Other generalized seizures can cause brief staring spells (absence seizures) or sudden muscle jerks (myoclonic seizures).

Warning signs: what is an aura?

Some people have warning signs in the moments before a seizure begins. These are called auras, and they are actually a type of focal seizure. Auras can feel different for each person. Common warning signs include a strange feeling in the stomach, a sense of fear, déjà vu, a strange taste or smell, or seeing a steady or flashing light, a color, or a shape. Some people may feel dizzy or lose their balance, and some may see things that are not there, known as hallucinations. Recognizing auras can be very helpful because they give you a heads-up that a seizure may be coming, allowing you to help the person get to a safe place.

How dementia and age affect seizure risk

Seizures can happen to anyone, but they are more common in older adults and in people with dementia. Different types of dementia can strike at different ages. For example, Alzheimer's disease typically affects older people, while frontotemporal dementia, Lewy body dementia, and Parkinson's disease dementia can appear in people in their 40s, 50s, and 60s. The type of dementia can influence the symptoms and progression of the condition. In people with dementia, a sudden change in mental status, increased confusion, or new seizure-like activity should always be evaluated by a doctor, as it could be a sign of delirium or another medical problem. Delirium, which is different from dementia, comes on suddenly and can look like a seizure in some cases. There are three types of delirium: hyperactive (agitation, hallucinations), hypoactive (lethargy, slowed movements), and mixed. If you suspect delirium, seek immediate medical help.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Stay calm and note the time the seizure started. If it lasts longer than 5 minutes, call 911.

  2. Guide the person away from hazards, lower them to the floor, and cushion their head with something soft.

  3. After the seizure ends, roll them onto their side into the recovery position and stay with them until fully alert.

  4. Observe and record: start and stop time, what they were doing beforehand, movements or behaviors during the seizure, and their state afterward—share this with the doctor.

  5. In dementia, a seizure may appear as a sudden spike in confusion or a staring spell; if this repeats consistently, note timing and details, and report it to the physician.

  6. For a first seizure, a seizure differing from their usual pattern, or multiple seizures in a row, contact the healthcare provider.

What not to do

  • Do not put anything in the person's mouth (fingers, spoon, cloth)—this can break teeth or cause choking.

  • Do not hold the person down or restrain their movements; clear hazards and let the seizure pass.

  • Do not give water, food, or any medication during or immediately after the seizure until they are fully alert and able to swallow safely.

  • Do not assume a brief staring spell in dementia is 'just daydreaming'; repeated episodes may be a seizure and should be reported.

  • Do not panic or argue if the person is confused or agitated after the seizure; this post-ictal state can last minutes to hours—speak softly and give space.

Practical tools

  • Seizure observation log

    Keep a notebook or phone note recording date, time, pre-seizure activity, observed movements or staring, and post-seizure behavior. This log is essential for the neurologist.

  • Home safety checklist

    Remove or pad sharp corners, clear floor clutter, and ensure the person is away from stairs, hot surfaces, or water during a seizure. Consider a low bed or bed rail to prevent falls.

  • Medical ID bracelet or card

    If the person has a known seizure disorder, use a medical ID bracelet listing condition, medications, and emergency contact. Keep a card in their wallet or purse.

  • Seizure Action Plan

    Obtain a written plan from the neurologist specifying seizure type, triggers, daily medications, any rescue medication and when to administer it, and exactly when to call 911. Keep copies at home, in your bag, and with other caregivers.

Discuss with your clinician

Ask your doctor: 'What type of seizure does my loved one have, and what should I do if it lasts longer than 5 minutes?'

Ask your doctor: 'Are there any medications that could trigger seizures in someone with dementia?'

Ask your doctor: 'Should we have a rescue medication (like a nasal spray) at home for prolonged seizures?'

Ask your doctor: 'What changes in behavior or confusion should I watch for that might indicate a seizure rather than just dementia progression?'

Ask your doctor: 'Is it safe for my loved one to drive or be left alone after a seizure?'

Related guides

Sources