First seizure and onset of epilepsy

We are giving you this information because your doctor believes you have had a seizure or developed epilepsy.

The diagnosis of epilepsy or a seizure is not straightforward, so we will refer you to a specialist epilepsy clinic for further assessment and advice. We will also offer you a new patient appointment.                                                                      

About seizures and epilepsy

Seizures

• A seizure (sometimes called a fit, an attack, a convulsion or a turn) is a sudden, brief disruption of normal brain activity. The seizure may have different forms, depending on whether it happens in your whole brain or part of your brain.
• A seizure may be triggered by stress, exhaustion, a bang to the head, pain, overuse of alcohol, use of drugs, or illness. There can be lots of different medical causes. For many patients, we are not able to identify the exact cause of the seizure.
• There are different types of seizure and not everybody loses consciousness.
• 50% of people never have another seizure.

Epilepsy

If someone has repeated, unprovoked seizures this is called epilepsy. We prescribe medication for most epilepsy patients.

Most patients whom we treat for epilepsy get better. Around 70% of patients lead a full life while taking one or two anti-seizure medications. Around 30% of patients continue to have seizures despite taking anti-seizure medications.

We recommend patients with epilepsy take their medications for at least 2 years. If they remain free of seizures after 2 years, we will discuss with them whether they need to continue with their medication.

Medication

• If we diagnose you with epilepsy and treat you with anti- seizure medications, you must take them regularly.
• Make sure you do not run out of your medications.
• Make sure you request a follow-up prescription from your GP at least 7 to 14 days before you run out. If you regularly use the same pharmacy, your pharmacist will be able to help you with this.
• When you start taking anti-seizure medication, you may need to take your other medications (for example oral contraception) at a different dose. Check with your GP or hospital doctor.
• Keep an up-to-date and complete list of all the medications you take. Bring it to every clinic appointment. Show this list to every doctor nurse or pharmacist who prescribes medications for you. Make sure they know you are taking anti-seizure medication.

Free prescriptions

You will be entitled to free prescriptions and can apply for a prescription charge exemption certificate.

To do this, use an FP92A application form. You can complete Part 1 and 2 of this form. Part 3 can only be completed by a GP or a member of your GP practice who has access to your medical records. This means you will need to attend your GP surgery to finalise the form.

NHS information on using the FP92A form

Staying safe after a seizure

You may be at risk of further attacks.

Even if you have already started treatment for seizures, we advise you to follow the safety advice listed below.    

Avoid situations where a seizure could have serious consequences for you and for other people.

Do not:

• Ride a bicycle. (If you have to cycle, stick to cycle ways, avoid heavy traffic routes, and always wear a helmet.)
• Work on ladders, roofs or scaffolding.
• Stand close to an unguarded open fire or flame.
• Swim alone. (Let the pool attendant know or take a friend with you).
• Try to shower, instead of taking a bath. If you do take a bath, do so in shallow water and keep the bathroom door unlocked. If possible, have someone else in the house who can check on you. 
• Stand too close to the edge of tube or train platforms. Avoid the kerb area on pavements.
• Operate potentially dangerous machinery, for example a chainsaw or heavy manufacturing equipment.

Driving

If your doctor believes you have had a seizure or developed epilepsy, you must not drive until you have been seen by a specialist epilepsy clinic.

Unless we find a treatable cause of your seizure, you are legally required to inform the DVLA. If you do not inform the DVLA, you can be fined up to £1000.

You will not be allowed to drive for at least 6 months (usually 1 year) after your most recent seizure.

This is for your own safety and the safety of other road users and pedestrians. 

For further guidance, visit: UK Government information on medical conditions, disabilities and driving

DVLA  medical enquiries: 0300 790 6806

First aid during a seizure

Most seizures stop on their own after a few minutes, and no emergency action is needed.

In case you have another seizure, it is a good idea to make sure your friends, family and colleagues know what to do if this happens. This will help ensure that they look after you, and will also reduce their own anxiety about your condition.

If you have a seizure, we advise your friends, family or colleagues to do the following.

• Keep calm.
• Ask for help if they are alone with you.
• Prevent others from crowding around you.
• Cushion your head by placing something soft under it, if you have fallen.
• Loosen any tight clothing around your neck.
• They can remove your glasses, but this is not essential.
• Check the time, to monitor how long your seizure lasts.
• Remove sharp, hot or hard objects from your surroundings.
• Guide you away from danger (for example stairs or the road) if you are confused.
• Only move you if you are in a dangerous place (for example at the top a staircase or in the road).
• Once the episode has finished, help you to breathe by putting you into the recovery position. See the NHS video below.
• If they suspect you have injured your neck, be careful when putting you into the recovery position.
• If your breathing is difficult, check nothing is blocking your throat (such as dentures, food or chewing gum).
• Stay with you until you are fully recovered and aware of your surroundings.
• Gently reassure you while you are recovering.

Tips for helping someone having a seizure

When helping someone who is having a seizure:

• Do not put anything in their mouth (there is no danger of them swallowing their tongue during a seizure).
• Do not restrain their convulsive movements or hold them down.
• Do not leave them until they have recovered.
• Do not give them anything to eat or drink until they are fully recovered.

Do call an ambulance if any of the following apply:

• Their seizure lasts longer than usual (or more than 5 minutes).
• They have more than one seizure without recovery time in-between.
• They have injured themselves or are having trouble breathing after their seizure.

Telling your employer

We advise you to tell your employer that you have had a suspected seizure or been diagnosed with epilepsy. This means you can talk to them about possible additional safety measures at your workplace.

If you have had a suspected seizure or been diagnosed with epilepsy, you must let your employer know if:

• Your job involves driving (any type of vehicle) or flying.
• You serve in the armed forces, police, fire service or merchant navy.
• You work at heights, near water, with heat sources or with machinery.
• You work with children or vulnerable adults.

More information

NHS information on epilepsy

Epilepsy Action

The Epilepsy Society

NHS Talking Therapies for anxiety (free to access on the NHS)

NHS Better Health on getting active

NHS Better Health on healthy eating

Wellbeing resources from South West London Integrated Care System

NHS information on drug and alcohol support and recovery