Seizures are sudden, uncontrolled brain disturbances that can lead to physical consequences. For those witnessing a seizure, blood from the mouth can be alarming. This is typically from involuntary actions during the seizure, not an internal brain hemorrhage. Understanding the mechanisms behind this bleeding and how to respond can alleviate concern.
Common Causes of Mouth Bleeding During Seizures
Mouth bleeding during a seizure primarily stems from trauma to the soft tissues within the oral cavity, rather than an internal injury. The most frequent cause involves involuntary muscle contractions, particularly in generalized tonic-clonic seizures. During the tonic phase, muscles stiffen, then jerk rhythmically in the clonic phase. These intense movements can cause a person to bite down forcefully.
Tongue biting is a common injury, often occurring along the sides of the tongue as it gets caught between the teeth during powerful jaw contractions. Trauma to the inner cheeks or lips can also happen when these tissues are inadvertently clamped between the teeth. These soft tissue lacerations, while appearing to produce a significant amount of blood, are generally superficial.
The forceful clamping of the jaw can also lead to dental trauma, such as chipped or broken teeth. Dental injuries like chipped, broken, or knocked-out teeth can occur. While less frequent than soft tissue injuries, dental damage can also contribute to oral bleeding during or immediately after a seizure.
Assessing the Seriousness of Oral Injuries
After a seizure, assess mouth bleeding to determine injury severity. Minor tongue, cheek, or lip bites typically present as small cuts or lacerations. Despite the appearance of a lot of blood, this is often due to saliva mixing with blood, making the volume seem greater. The oral cavity has a rich blood supply, but many such injuries are superficial and will stop bleeding on their own.
Pain and discomfort are expected following an oral injury, usually subsiding as the wound heals. However, certain signs suggest a more serious injury requiring prompt attention. These include excessive, uncontrolled bleeding that does not stop after 10-15 minutes of direct pressure, or deep, gaping wounds that might need stitches. Difficulty swallowing or persistent pain beyond what would be expected for a minor cut are also concerning.
Obvious dental damage, such as a severely broken or knocked-out tooth, warrants professional dental care. Any developing signs of infection in the days following the injury, such as increasing pain, pus, redness, or fever, should be evaluated by a healthcare professional.
Immediate Response and When to Seek Medical Care
During a seizure, the primary goal of first aid is to protect the person from injury, not to prevent oral trauma by placing objects in their mouth. Attempting to force something into the mouth can cause more harm, potentially leading to broken teeth or choking. A person cannot swallow their tongue during a seizure. Instead, ensure the area around the person is clear of dangerous objects and cushion their head with something soft.
After the seizure concludes, if oral bleeding is present, turn the person gently onto their side to help prevent choking on blood or saliva. To control bleeding from minor cuts, apply gentle, direct pressure to the injured area with a clean cloth or gauze for at least 15 minutes without peeking. Once bleeding is controlled, a gentle rinse with water or a mild salt solution can help clean the mouth. Offering ice chips or cold liquids can also provide comfort and reduce swelling.
Medical attention is necessary in several situations. Call for emergency medical help if bleeding is heavy or does not stop after 10-15 minutes of continuous direct pressure. Deep lacerations that may require sutures, or suspicion of a broken or knocked-out tooth, warrant a visit to a dentist or emergency room. Seek medical advice if there are signs of infection, persistent difficulty breathing or swallowing, or other concerns about the person’s condition.