Seizure Emergencies

A seizure is an emergency when it lasts a long time or when seizures occur close together and the person doesn't recover between seizures. Just like there are different types of seizures, there are also different types of emergencies.

A series of continuous seizures that last over a period of time and may cause brain injury

  • Happens when a seizure lasts longer than 5 minutes or when seizures occur close together and the person doesn’t recover between seizures
  • Convulsive seizures that last longer than 5 minutes should be considered a medical emergency, and someone should call 911
  • Tests may be needed to understand if status epilepticus is being caused by something happening in the brain, such as a brain tumor or a brain infection

  • A more common form of seizure emergency that can occur with prolonged or repeated tonic-clonic seizures
  • Happens when:
    • The active part of a tonic-clonic seizure lasts 5 minutes or longer (some seizures have after-seizure symptoms for much longer)
    • A person goes into a second seizure without regaining consciousness from the first one
    • A person has repeated seizures for 30 minutes or longer

  • Involves long or repeated absence seizures or focal impaired awareness (complex partial) seizures
  • Person may be not be fully aware, but not unconscious like with tonic-clonic seizures
  • Harder to recognize because of less intense symptoms
  • Timeframe for being declared an emergency depends on how long the person’s typical seizures might last and how often they occur

  • These seizure types may not be an emergency on their own, but if seizures become longer over time, or occur closer together without stopping in between, it could be a problem
  • Talk to your doctor if you are having a lot of seizure clusters, or if the seizures are different from their normal pattern

Seizure clusters = 2 or more seizures in 24 hours

  • Seizures within the cluster are normally back-to-back with a short recovery time in between seizures
  • Seizure clusters are not limited to one particular seizure type
  • Be aware of seizures that get longer or start getting closer together—this can lead to status epilepticus
    (a life-threatening emergency)
  • The key to stopping an emergency is noticing unusual seizure patterns and taking rescue medication (medication used only for seizure clusters, not your daily seizure medication)

Seizure clusters may also be called:

  • Acute repetitive seizures
  • Serial seizures
  • Crescendo seizures
  • Seizure flurries

Be ready with a plan!
Download a Seizure Action Plan to prepare for emergencies

Sudden Unexpected Death in Epilepsy (SUDEP)

SUDEP is a sudden unexpected death related to epilepsy. It is not caused by drowning or another type of accident that could lead to death while having a seizure. SUDEP can happen with or without a seizure.

SUDEP might be hard to talk about, but knowing that it could happen is an important part of prevention.

Here are some facts about SUDEP:
  • About 1 in 1000 adults with epilepsy in the US die of SUDEP each year
  • Frequent seizures, especially generalized tonic-clonic seizures, are the greatest risk factor for SUDEP
  • One of the most common epilepsy-related causes of death
  • Among neurologic conditions, SUDEP ranks second, after stroke, in years of potential life lost

Risk Factors for SUDEP

Living with epilepsy for a long time
Nighttime seizures
Many uncontrolled seizures
Frequent generalized
tonic-clonic seizures

Until further answers are available, the best way to prevent SUDEP is to lower your risk by controlling seizures. You may find it helpful to talk to your doctor about your possible risk of SUDEP.

Make the Most of Your Doctor’s Visit

A handy guide to help start your health conversations

Need to change your medication? Always talk with your doctor before making any changes in medication.