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Warning-sign checks

Refractory epilepsy: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services if:

    • A seizure lasts five minutes or longer
    • Another seizure starts before the person recovers
    • Breathing remains difficult after the shaking stops
    • The seizure occurs in water
    • There is a serious injury
    • It is the person's first known seizure

    And for anyone, someone who:

    • has had a seizure that will not stop, or does not wake up afterwards
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Do not wait for the next scheduled visit if treatment has become difficult to follow.

    Seek urgent medical advice after a significant seizure-related injury, a first seizure during pregnancy, or a seizure pattern that is clearly different from usual.

    Follow your individual seizure action plan if you have one.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange routine follow-up if seizures continue, become more frequent, change in pattern, or cause troublesome side effects.

    Contact your epilepsy team if you are missing medicine because of cost, swallowing problems, pregnancy, or side effects.

The article also says

During a convulsive seizure, move nearby hazards, cushion the head, and time the event.

Do not restrain the person or put anything in their mouth.

When the shaking stops, turn them onto their side if it is safe to do so and stay with them while they recover.

Every sign above is quoted from the sofidex article on Refractory epilepsy. If you are not sure, err upward — it is always reasonable to be checked.