First fit (seizure)

There are many different types of seizures and not everybody will lose consciousness. You have had tests today to check for important causes of seizures.

Do I have epilepsy?

Around one in every thirty people will experience a seizure in their lifetime. Having a seizure does not mean you have epilepsy. There are several different causes for seizures besides epilepsy. A diagnosis of epilepsy is rarely made after a single seizure.

What will happen next?

You will have had tests to see if a cause for the seizure can be found. Often no cause is found. Around half of people who have a seizure will never have another. After a first seizure, you will not generally need to be admitted to hospital. Most people can be safely sent home when they have recovered and are otherwise well.

Treatment to prevent seizures is rarely given after a single seizure. Most patients will be referred to a specialist clinic for further assessment. You should receive an appointment letter in the post for this. If you have not heard back within 2-4 weeks, please contact the neurology secretaries via: 0114 2434343.

Is it safe for me to drive?

If you hold a driving licence, you must inform the DVLA of your suspected seizure. You must not drive until the DVLA has given you permission to do so. The decision the DVLA makes will also depend on the advice from the specialist who will follow you up:

• you will not be allowed to drive a car for between 6 to 12 months after a first seizure
• it is your responsibility to contact the DVLA. You may be fined up to £1000 and your insurance will be invalidated if you do not inform them
• you may be entitled to a free bus pass if you are disqualified from driving on medical grounds

Other vehicles:

1. Forklift licence: The restriction is the same as that for a car.
2. Bus or lorry (Group 2 licence): The driving restriction is different, and longer, for a group 2 licence. You can get more information about this from the DVLA.
3. Taxi: If you drive a taxi, you must inform the DVLA.  You must also contact the issuer of your taxi licence. Local authorities set their own standards for taxi drivers.

How do I get information about driving and notifying the DVLA?

You can call the DVLA on: 0300 790 6806.

You can pick up an information pack at your local post office. This will help you to update your driving license.

For more information on contacting the DVLA, visit their website.

What do I tell work?

It is sensible to tell your line manager or occupational health department. You should discuss whether any extra safety measures need to be taken.

You have to inform them if:

• your job involves driving any vehicle, or flying an aircraft
• you are in the armed forces, police, fire service or merchant navy
• if you, or anyone else could be at risk if it happened again; for example, if you work at heights, near water, with machinery or with vulnerable groups of people

Do I need to change my lifestyle?

General lifestyle advice: Most seizures do not have a clear trigger. You should continue to lead a healthy life. You should take care in situations where sudden loss of consciousness could be risky. For example, near water or at heights.

Alcohol: Alcohol dependence can cause seizures. It is important not to stop drinking suddenly. You should seek professional help if you have alcohol addiction leading to a seizure. Your GP can tell you about this, or you can call the national alcohol helpline on: 0300 1231110.

Recreational drugs: Some recreational drugs can cause seizures, particularly cocaine and synthetic cannabis. There is no evidence that caffeine causes seizures.

Late nights and drinking: Some types of seizure are triggered by lack of sleep or heavy binge drinking. It is advisable to avoid sleep deprivation and to only drink alcohol in small amounts.

Screens: It is uncommon for seizures to be triggered by flashing lights. TV screens and video games rarely flash at a frequency which triggers seizures. There is no need to avoid watching TV or using screens after a single seizure.

How can I reduce the risk of injury in a seizure?

Have a shower rather than a bath.

If you go swimming, tell the pool attendant that you have had a seizure before. Avoid swimming unless there is a lifeguard present.

Avoid unprotected heights.

Avoid using moving machinery. This could cause injury if you were to become unconscious and fall.

Let people know where you are and when you expect to be back; if possible avoid lone activities.

First aid information for your family, friends and colleagues

Do:

• keep calm and prevent others from crowding
• check the time; record how long the seizure lasts
• loosen any tight clothing around the neck
• protect the person from injury (remove sharp or hard objects from the area, and if they are confused, guide them away from danger such as stairs or the road)
• if they have fallen, place something soft under their head
• position the person on their side and gently lifting their chin (recovery position); this will help with their breathing
• stay with them until they have fully recovered and are aware of their surroundings; gently reassure them as they recover

Don't:

• try to restrain the person or their movements
• put anything between their teeth or in their mouth
• try to move them, unless they are in danger
• give the person anything to eat or drink until they are fully recovered

When should 999 be dialled for an ambulance?

An ambulance should be called for if:

• a shaking (convulsive) seizure lasts more than 5 minutes
• one convulsive seizure follows another without the person regaining consciousness between
• the person has injured themselves during a seizure
• the person is having difficulty breathing when the seizure has finished
• the person has 3 convulsive seizures in an hour
• you have other concerns about the person’s wellbeing

How do I describe what has happened?

There is no single test which will give the diagnosis of an epileptic seizure.

The doctor is likely to be interested in the following information:

• what was the person doing before the episode started?
• what was the first sign that something was wrong?
• did they lose consciousness, become vacant, or were they confused?
• did their skin colour change?
• did their breathing alter?
• were there any movements in their body or limbs?
• did they bite their tongue?
• were they incontinent (did they pee or soil themselves)?
• how long did the episode last?
• how long was it before they could go back to their normal activities?
• the date and time that an episode happened

If further seizures occur, a video of events can be very useful in diagnosis. If the patient has lost consciousness, it is very important for a witness to be available to contact. Ideally, they would come to the hospital. If they cannot be available, please ask them to provide a written account.

Where can I get further information?

Epilepsy Action:

• you can call Epilepsy Action on: 0808 800 5050
• you can visit the Epilepsy Action website for more information

Epilepsy Society:

• you can call the Epilepsy Society on: 01494 601 400
• you can visit the Epilepsy Society website 

These organisations help people with epilepsy. They can also provide useful information for people who have had a first seizure. 

Reviewed by Dr T Shaw in September 2023, next review in September 2024. 

If you need this information in an alternative format, please contact the Patient Experience and Engagement Team on 01226 434922.

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