Frequently Asked Questions about Seizure Emergencies

Are most seizures emergencies?

No. Fortunately, most seizures are not emergencies. The average generalized tonic clonic or grand mal convulsion – the kind of seizure everyone is most familiar with – generally lasts about two minutes. Complex partial seizures last about the same time, although people may take longer to completely recover. Drop attacks are brief; staring spells -- also known as absence -- and last only seconds. Seizures are generally self-limiting – the brain runs out of excessive energy.

What makes a seizure an emergency?

The type of seizure is important. Seizures that affect breathing –  generalized tonic-clonic seizures – are more likely to become emergencies, especially if prolonged or occur in series. Seizures that occur in hazardous environments may require an emergency response. Patient age may be a factor in whether seizures are emergencies, and so may other health issues --  such as pregnancy, the presence of other illnesses, such as diabetes -- and seizure-related injury.

How important is time during an emergency situation?

It is VERY important for the following reasons: The risks of brain damage or even death increase with seizure duration; seizures lasting more than a few minutes are less likely to stop on their own; seizures beyond five minutes progress to become status epilepticus; clusters of seizures may also progress to status epilepticus.

What is status epilepticus?

Status epilepticus is a true medical emergency that requires medical intervention to bring the seizure to an end.

A seizure officially becomes a status seizure if it has lasted for more than 30 minutes without stopping. However, any prolonged seizure that continues for five minutes beyond the usual length for an individual, should be regarded as an emergency until proved otherwise. A prolonged seizure may progress to become status epilepticus. Any type of seizure may become a continuing event, but the risk of brain damage and physical stress on the heart is greatest with a generalized tonic-clonic seizure.

Similarly, flurries and clusters of seizures, happening one after the other, may herald a growing risk of becoming an emergency situation. The longer the seizure lasts, the greater the risk of a fatal outcome. Although the death toll from status seizures has lessened in recent years, it is still estimated to result in thousands of deaths annually. Many of these deaths are among people who do not have epilepsy but have status episodes triggered by other medical problems.