Seizure

Background

Seizure consists of involuntary muscle contractions due to disturbance in electrical activity of the brain. It presents with sudden loss of consciousness and jerking of the extremities in most cases. In rare cases, consciousness is preserved.

In elderly, the most common causes of seizure include epilepsy, Alzheimer’s disease, stroke and medication. Seizure can also be caused by head injury, brain-damaging disease (neurodegenerative diseases, tumor, and infection), and lack of nutrients in brain (hypoglycemia, acute alcohol intoxication or drug withdrawal)

Symptoms and signs

- Sudden loss of consciousness - Arching of back - Breathing difficulty (grey-bluish lips, red and puffy face/neck) - Convulsive movements (clenched jaw with noisy breathing, tongue- biting, drooling or foaming of saliva, facial twitching) - Urine or bowel incontinence - Tiredness and sleepiness after seizure

The elderly may have brief warning symptoms (aura) just before seizure, for example, strange dizzy feeling, and special smell/taste. He/she may regain consciousness in a few minutes, and may be unaware of the actions.

! Repeated seizures within a short time ! Having the first seizure ! Seizure lasts for > 5mins ! Loss of consciousness for >10mins ! Limb weakness or paralysis after the seizure has stopped

As a first aider

- Look for red flags and manage as medical emergency - Protect the seizing elderly from injury - Maintain a patent airway and smooth breathing during and after the seizure when the elderly is not fully conscious

Do’s

1. Seek emergency medical help as soon as possible 2. Protect the elderly - clear away any potentially dangerous objects to prevent injury of the elderly, pad the area with clothing or pillows if the elderly is close to wall or hard objects, ask bystanders to keep clear 3. Protect the head and loosen tight clothing around neck 4. Lie the elderly down in recovery position (if not suspecting a spinal injury) 5. Monitor closely the responsiveness level and breathing; open airway 6. Note the time of onset and duration of seizure 7. Check for any injuries and apply necessary first aid

Don’ts

1. Move the elderly unnecessarily 2. ut anything in his mouth or attempt to restrain him or her during a seizure 3. Give food and drinks