Epilepsy and Seizures

Epilepsy is a neurological condition, which means it affects the brain. It causes a tendency to have repeated seizures.

A seizure happens when there is a sudden burst of unusual electrical activity in the brain. Depending on where in the brain that happens, a seizure can affect movement, awareness, sensations, feelings or behaviour.

Not every seizure is caused by epilepsy. Seizures can also happen because of a high temperature, a head injury, low blood sugar, alcohol or drug withdrawal, and several other causes.

Having one seizure does not automatically mean someone has epilepsy. A diagnosis is usually considered when someone has a tendency to have seizures that keep happening.

Epilepsy is not infectious and cannot be passed from one person to another.

Seizures do not always involve falling down or shaking. Many seizures are far quieter and are easy to miss or mistake for daydreaming, confusion or odd behaviour.

A seizure may involve:

• Losing awareness of surroundings.
• Staring blankly and not responding.
• Sudden confusion.
• Unusual sensations, smells, tastes or feelings.
• Tingling or numbness.
• Repeated automatic movements, such as lip-smacking or picking at clothing.
• Stiffening of the body.
• Rhythmic jerking or shaking.
• Suddenly falling.
• Brief muscle jerks.
• Temporary loss of consciousness.
• Feeling tired, confused or unwell afterwards.

Symptoms vary depending on which part of the brain is involved. Two people with epilepsy may have completely different seizures, and one person can have more than one type.

Anyone who may have had a first seizure needs urgent medical assessment. If they were not taken to hospital at the time, they should contact their GP promptly.

Contact the person’s epilepsy team, GP or NHS 111 if seizures change, become more frequent, recovery takes longer than usual, or treatment is causing troublesome side effects.

A suspected seizure can have other causes, including fainting, heart problems, low blood sugar, infection or a non-epileptic seizure. That is one reason a proper assessment matters. Our GP Services page explains how appointments and referrals usually work, and Delirium and Sudden Confusion covers other causes of sudden confusion.

There is no single test that proves someone has epilepsy. Diagnosis is built up from several pieces of information.

Assessment may include:

• A detailed description of what happened before, during and after the event.
• Information from someone who witnessed it — this is often the most useful evidence.
• Medical and family history.
• A neurological examination.
• Blood tests.
• An ECG to check the heart.
• An EEG to record electrical activity in the brain.
• An MRI or other brain scan.

Diagnosis should be made by an appropriate specialist, and it may take time because several other conditions can look very like epilepsy. A normal EEG or scan does not on its own rule epilepsy out.

Treatment helps many people have fewer seizures, and many people become seizure-free. Care is usually shared between a specialist team and a GP.

• Anti-seizure medicines — the main treatment for most people.
• Regular specialist reviews to check how well treatment is working.
• Surgery for a small number of people whose seizures are suitable for it.
• Devices that stimulate particular nerves or parts of the brain.
• A medically supervised ketogenic diet in selected cases.
• Support with memory, mood, education, employment and independence, where these are affected.
• An individual seizure care or emergency plan setting out what to do.

This page does not give doses or recommend a particular medicine. Those decisions belong with the prescribing doctor or epilepsy specialist, who will take the seizure type, age, other conditions and other medicines into account.

Most people with epilepsy live full, independent lives. A few simple habits reduce risk without taking over daily life:

• Showers are generally safer than baths while seizures are not fully controlled.
• Avoid swimming alone — go with someone who knows what to do.
• Take extra care around heights, open flames, hot surfaces and machinery.
• Use guards on heaters and radiators where appropriate.
• Have a personal seizure plan and share it with the people around you.
• Teach relatives, friends, carers or colleagues basic seizure first aid.
• Wear medical identification if you choose to — it is a personal decision.
• Keep regular sleep, as tiredness can make seizures more likely for some people.
• Discuss alcohol, pregnancy and contraception with the epilepsy team.
• Seek advice if seizures happen during sleep, as the plan may need adjusting.

Anyone who has an epileptic seizure or blackout must stop driving and check the DVLA rules. The exact rules depend on the type and circumstances of the seizure. Do not assume that a previous licence remains valid.

Individual circumstances differ, so check the official guidance rather than relying on a summary: GOV.UK — Epilepsy and driving.

Epilepsy can affect confidence, relationships, education, work, travel and mental health. Losing a driving licence, worrying about a seizure in public, or feeling that others do not understand can all take a toll.

If you experience anxiety, low mood, isolation or difficulty coping, speak to your GP or epilepsy team. Support is available and asking for it is a sensible step, not a weakness. Our Mental Health page explains what help exists and how to reach it.

• NHS — Epilepsy
• NHS — What to do if someone has a seizure
• NICE guideline NG217 — Epilepsies in children, young people and adults
• Epilepsy Action
• Epilepsy Action — facts and terminology
• Epilepsy Society — seizure first aid
• GOV.UK — Epilepsy and driving

Important notice: Sixpence Support UK provides general information only. This page is not a diagnosis, medical advice, or a substitute for assessment and treatment by a qualified healthcare professional. Always speak to a GP, pharmacist or another qualified health provider about your own symptoms, medicines and circumstances. In an emergency, call 999.