For the family and friends of someone with epilepsy, watching out for their loved one just comes with the territory. But what about when a person without a history of seizures suddenly experiences one? What does it mean and what happens next?

According to the American Epilepsy Society, one in 26 Americans will develop epilepsy or recurring seizures at some point during his or her lifetime. While the condition is more common in children and older adults, it affects all ages, races and socioeconomic groups.

Catrina Nieser, neuroscience program coordinator at Texas Health Presbyterian Hospital Dallas, recommends steps to take during the seizure to ensure safety.

“If someone around you has a seizure, first focus on making sure he is safe,” she says. “Put a pillow behind his head so he doesn’t hurt himself. Don’t hold him down and never put anything in his mouth. Once it’s over, the person may be very disoriented.”

Hamid Kadiwala, M.D., neurologist and physician on the medical staff at Texas Health Fort Worth, says that while dealing with immediate needs of the person with a seizure is the most important thing, pay attention to details as best you can.

“Seizures are a clinical diagnosis,” Kadiwala says. “There are no blood tests to confirm them and they rarely happen in front of us. If people see it and their observations support a diagnosis, their input can help guide us as to what type it was and how to best move forward. It’s scary at the time but record the person on your phone if it can be safely done. Most people aren’t trained to know what to look for and sometimes their observations can be misleading, as we may have different definitions of shaking or a tremor.”

Once the seizure is over, Kadiwala recommends the patient be taken to the emergency room to rule out any serious medical problems.

“Anyone who experiences their first seizure should be taken to the ER right away,” he explains. “The purpose of an ER visit is to rule out any immediate or life-threatening. After the ER visit, if things check out okay, the patient will be sent home. They will be directed to follow up with their primary care physician and likely get a referral to a neurologist.”

While seizures on television are usually of the tonic-clonic variety which show the person jerking uncontrollably or going rigid, they are much more complicated in real life. Seizures not only are caused by different things but may also look very different from person to person, depending on where in the seizure is coming from.

“Everybody thinks seizures are these very obvious things, but a lot of times after you have your first big seizure, you’ll realize things had been happening for a while,” Nieser explains. “There may have been times when you lost time and didn’t know why. Your family might think you’re absent-minded, but in reality, you were blanking out.

“Once you have your first seizure, go back and think about your history. Were there times weird things happened that you couldn’t explain? You may have been having seizures longer than you think.”

It’s important to note that seizures aren’t always the result of epilepsy but may be caused by many other medical issues such as illness, particularly in children, or negative lifestyle patterns.

“There is a difference between seizures and epilepsy,” Kadiwala explains. “A seizure is a provoked symptom of something wrong. A patient may have one and then everything looks okay after we’ve checked them out.

“Epilepsy is a disease when seizures occur multiple times so a patient has to be on medication. If a person has one seizure and everything then everything checks out, the likelihood of having another is low. On the other hand, if a person has more than one seizure, they are very likely to continue having them, so medication is necessary.”

Once a person has a seizure, he may wonder if he’s destined to experience more incidents. The cause and type of a person’s seizures will determine how a physician will treat his condition and predict the likelihood of a recurrence.

“Medication is the common treatment for patients with epilepsy, but there are other treatments available if medication isn’t effective,” Kadiwala explains. “Each year, more medications come onto the market, so we have lots of options. The number one cause of re-occurrence is stress and a lack of sleep, so it’s important to not only take medication but handle lifestyle issues as well.”

Once a person has their first seizure, it’s common for people to have anxiety about having another one. Nieser says the best way to combat fear is to get active and connect.

“Some of these individuals become shut-ins because they are so fearful of having another seizure and they worry about how other people will perceive them,” she explains. “The first thing to do is reach out to a support group of people who have been through something similar. The Epilepsy Foundation of Texas is a good resource. There is also a monthly online Facebook Live support group presented by Texas Health Dallas that presents relevant information and the ability to connect with others.

Email THDNeurosciences@TexasHealth.org for more information.

“Fear can eat away at you, but you can’t withdraw from your life because of what might happen. Talk to others, go for a walk, rely on your family and friends for support, and find ways to relieve your stress. Some people live under a dark cloud because of their seizures, but you can decide to not let it control you. Try not to think about it all the time and focus on things that make you feel better.”

To find a neurologist with Texas Health Resources who can help you manage your seizures and any complications, visit TexasHealth.org/provider.