What to do if a seizure follows a crash head injury
First aid and follow up advice from a neurologist and an emergency medicine provider
A seizure can happen after a serious head injury. The person may shake, stare, lose awareness or move in unusual ways. It is scary to watch. As a helper, your first job is to keep the person from getting hurt again and to get the right help. A neurologist looks into the cause and the treatment. An emergency care provider checks a new seizure or any dangerous change. [1, 2]
How to help while it's happening
Check the time when it starts. Move hard or sharp objects out of the way. Put something soft under the head if you can. Don’t hold the person down. Never put anything in their mouth. [2, 3]
If they’re lying down, gently roll them onto one side once it’s safe. A neck or spine injury may still be a concern. If so, follow the emergency dispatcher’s directions before you move them. Stay with them until they’re awake and safe. [2, 3]
When to call for emergency help
Call emergency services if it’s a first seizure or if it lasts longer than five minutes. Call too if another seizure follows soon after or the person has trouble breathing or waking up. The same goes for an injury during the seizure or a seizure in water. Any seizure after a recent head injury also needs a prompt medical exam. If the person isn’t fully alert, don’t drive them yourself. [1, 2, 3]
Notes that help the doctor later
Once the person has recovered, write down what you saw. Include the time, the movements, their awareness, their breathing and any injury. Note how long it took them to act like themselves again. A video may help the neurologist, as long as making it doesn’t delay first aid. [1, 2]
Ask whether medicine is needed and how long it’s meant to last. Find out what a missed dose means and who to call after another seizure. Do not stop a prescribed seizure medicine on your own. [1, 2]
Ask about limits on driving, swimming, heights and being alone. These stay in place until the treating doctor clears them. The rules may depend on the seizure and on local law. With a written plan, family and coworkers can respond without guessing. [2]
What to ask after a seizure
- Was this a seizure, and what checkups does it call for?
- What’s the plan if it happens again?
- Which activities are off limits until the next review?
Post the plan where helpers can see it
Put the emergency steps and your treating team’s phone number in a spot where anyone helping at home can find them. [2]
Sources and further reading
General education from neurology and emergency medicine. A first seizure after a head injury needs an emergency exam. If the person has a seizure plan of their own, follow it.
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