You cannot stop a seizure once it starts, but you can keep the person safe, use a prescribed rescue medication if one is available, and recognize when to call 911. Most seizures end on their own within one to three minutes. Your job during that time is protection, not intervention.
What to Do During an Active Seizure
The moment you see someone having a convulsive seizure, start by easing them to the ground if they’re standing or about to fall. Clear the area around them of furniture, sharp objects, or anything they could strike. Place something soft and flat under their head, like a folded jacket or sweater. Remove their eyeglasses and loosen anything around their neck that could restrict breathing, such as a tie or tight collar.
Once they’re on the ground, gently roll them onto their side with their mouth pointing toward the floor. This position keeps their airway clear and lets saliva drain rather than pooling in the back of the throat. Start timing the seizure immediately. If it lasts longer than five minutes, call 911. A seizure lasting beyond that threshold is a medical emergency called status epilepticus, which can cause brain injury without treatment.
Stay with the person the entire time. Speak calmly. When the seizure ends, they will likely be confused, exhausted, or disoriented. That recovery period is normal and typically lasts between five and 30 minutes, though it can stretch longer.
What You Should Never Do
Do not put anything in the person’s mouth. The old belief that someone can swallow their tongue during a seizure is anatomically impossible. Placing a wallet, spoon, or finger between their teeth risks breaking teeth, injuring the jaw, or causing you a serious bite wound. Every modern medical guideline advises against it.
Do not hold the person down or try to restrain their movements. Convulsive seizures involve involuntary muscle contractions, and fighting against them can cause fractures or joint injuries. Do not attempt CPR during the seizure itself. Do not offer food or water until the person is fully alert and responsive afterward.
Rescue Medications for Known Epilepsy
If the person has epilepsy and carries a prescribed rescue medication, this is the one situation where you may be able to shorten or stop a seizure. These fast-acting medications are designed for use outside a hospital, and caregivers can administer them without medical training once they’ve been shown how.
The most common rescue options work through three delivery routes. A nasal spray version of midazolam is sprayed into one nostril while the person is on their back. A buccal form of midazolam is placed between the cheek and gum, where it absorbs through the lining of the mouth. Rectal diazepam, delivered as a gel, is another option, particularly for children, though many families find it less practical. All of these medications belong to the same drug class and work by calming excessive electrical activity in the brain.
The person’s neurologist will have specified when to use the medication, typically if a seizure lasts beyond a certain number of minutes or if seizures begin clustering. A seizure cluster, generally defined as two or more seizures within six to 24 hours, is a common trigger for using rescue medication. Follow the specific instructions on the prescription, including whether a second dose is appropriate.
Using a Vagus Nerve Stimulator Magnet
Some people with epilepsy have an implanted vagus nerve stimulator, a small device under the skin of the chest that sends regular electrical pulses to the brain. These patients carry a handheld magnet that can trigger an extra burst of stimulation when a seizure begins or when they feel one coming on.
To use it, pass the magnet over the generator (located in the upper left chest area) for less than two seconds. You can swipe the magnet more than once during a single seizure without any risk of harm. Family members, caregivers, teachers, and the person themselves can all use the magnet. It won’t stop every seizure, but it may shorten or reduce the severity of some.
When to Call 911
Five minutes is the critical number. If a seizure lasts longer than five minutes, or if the person has a second seizure without fully regaining consciousness between episodes, call emergency services. Both scenarios meet the definition of status epilepticus and require hospital-level treatment.
Beyond the five-minute rule, call 911 if:
- This is the person’s first known seizure
- The person is pregnant
- The person has diabetes
- The seizure happens in water
- The person is injured during the seizure
- The person does not return to normal consciousness afterward
- The person is not breathing normally once the seizure ends
If you know the person has epilepsy and their seizure follows their typical pattern and ends within a few minutes, an ambulance may not be necessary. But when in doubt, calling for help is always the safer choice.
Helping During the Recovery Phase
After a seizure ends, the person enters a recovery period that can look almost as alarming as the seizure itself. They may be confused, unable to speak clearly, agitated, or sleepy. Some people experience headaches, muscle soreness, or temporary weakness on one side of the body. This phase averages five to 30 minutes but occasionally lasts hours or, rarely, up to a day.
Stay with them and speak in a calm, reassuring tone. Let them know where they are and what happened. Don’t rush them to stand up or answer questions. Once they’re alert, help them get to a comfortable place to rest. Many people need to spend several hours, or even the remainder of the day, resting and avoiding anything mentally or physically demanding. An over-the-counter pain reliever can help with the headache that often follows. If the recovery period stretches beyond 24 hours, that warrants a call to their doctor.