- Foaming at the Mouth
- Tonic-Clonic (Grand Mal) Seizures
- Symptoms of a Tonic-Clonic (Grand Mal) Seizure
- What to Do If Someone Has a Tonic-Clonic (Grand Mal) Seizure
- Diagnosis and Treatment of Tonic-Clonic (Grand Mal) Seizures
- First Aid: Seizures
- First aid quick guide
- How to help if someone is having a seizure
- When to call 999
- How to Help Someone Who’s Having a Seizure
- How to know if someone’s having a seizure
- What to do — and not do — when someone’s seizing
- When is a seizure an emergency?
- How to tell a seizure apart from another medical problem
Foaming at the Mouth
1. Drug overdose
People use recreational drugs because they affect the brain chemistry, causing feelings like euphoria and cravings for more of the drug. Two of the most popular categories of drugs are opioids (painkillers) and stimulants, or “uppers.”
Common opioids are:
Common stimulants are:
If you take too much of one of these drugs, you could overdose, meaning your body can’t detox the drug before deadly symptoms take effect.
Common signs of opiate or stimulant overdose are:
- foaming at the mouth or a foam cone
- loss of consciousness
- difficulty or stopped breathing
Overdose causes foaming at the mouth because organs like the heart and lungs can’t function properly. Slowed heart or lung movements causes fluids to gather in the lungs, which can mix with carbon dioxide and come out of the mouth like a foam.
Drug overdoses can be fatal. The drug narcan is an antidote to opiate overdose. There is no treatment for stimulant overdose.
When a person starts convulsing uncontrollably, they are having a seizure. A brain condition called epilepsy can cause seizures. There are also nonepileptic seizures, typically caused by trauma or psychological conditions.
Beyond convulsions, seizures can also cause:
- loss of consciousness
- frothing at the mouth or drooling
- biting your tongue
Foamy saliva can occur during a seizure because the mouth is forced closed, which stimulates the salivary glands and makes you produce extra spit. When the mouth opens again, drool or frothy saliva can come out.
Foaming at the mouth can also occur following a provoked seizure. For example, one case study examined a police officer whose partner accidentally shot him in the head with a Taser while chasing a suspect. The second officer witnessed his colleague lose consciousness, fall to the ground, and begin foaming at the mouth.
Treatments for seizures include antiepileptic medication and brain surgery.
Rabies is a viral disease that affects the central nervous system. Only warm-blooded animals can get rabies. Common carriers of the rabies virus are:
Animals less commonly affected by rabies are:
The rabies virus is present in the saliva. If an affected animal bites you or licks an open wound or scratch you have, you may get it.
Rabies can only be diagnosed from a brain tissue sample, so it’s important to watch for symptoms of the virus. Foaming at the mouth is the most characteristic symptom of rabies. This happens because the virus affects the nervous system and the animal or person can’t swallow their saliva.
Other symptoms are:
- lost appetite
- violence and biting
There is no way to treat rabies. If you think you have been exposed to rabies, clean your wound with soap and water and put a muzzle on your pet. Then immediately visit an emergency room where you will be given a rabies vaccine.
Tonic-Clonic (Grand Mal) Seizures
Symptoms of a Tonic-Clonic (Grand Mal) Seizure
The seizure may start with a simple or complex partial seizure known as an aura. The person may experience abnormal sensations such as a particular smell, vertigo, nausea, or anxiety. If the person is familiar with having seizures, they may recognize the warning signs of a seizure about to begin.
When the tonic-clonic seizure begins, the person loses consciousness and may fall. Strong tonic spasms of the muscles can force air out of the lungs, resulting in a cry or moan, even though the person is not aware of their surroundings. There may be saliva or foam coming from the mouth. If the person inadvertently bites their tongue or cheek, blood may be visible in the saliva.
Stiffness of the chest muscles may impair breathing, the person’s face may look bluish or gray, and he or she may make gasping or gurgling sounds.
Jerking movements affect the face, arms and legs, becoming intense and rapid. After one to three minutes, the jerking movements slow down and the body relaxes, sometimes including the bowel or bladder. The person may let out a deep sigh and return to more normal breathing.
After the Seizure (Postictal Period)
After a seizure, the person may remain unconscious for several minutes as the brain recovers from the seizure activity. He or she may appear to be sleeping or snoring.
Gradually the person regains awareness and may feel confused, exhausted, physically sore, sad or embarrassed for a few hours. The person may not remember having a seizure, and may have other memory loss. Occasionally, people may have abnormal or combative behavior after a tonic-clonic seizure while the brain is recovering.
What to Do If Someone Has a Tonic-Clonic (Grand Mal) Seizure
Witnessing a person having a tonic-clonic seizure can be upsetting, but it’s important to remember that most seizures resolve on their own after one to three minutes. To offer assistance:
Protect the person from injury by helping them to the floor and clearing away furniture or other items. Do not attempt to hold the person still.
Do not put anything in the person’s mouth. It is physically impossible to swallow one’s tongue, and putting things in the mouth may lead to injury.
Time the seizure.
A seizure lasting more than 5 minutes is an emergency. Call 911.
Calm reassurance can be helpful to a person who is recovering from a seizure.
Diagnosis and Treatment of Tonic-Clonic (Grand Mal) Seizures
After a person’s first seizure, it is important to consult with a physician. Parents or family members who observe the seizure can note the details and help create a written report that the person can take to the doctor. A video recording of the event (if available) can also aid in diagnosis.
To ascertain the cause of the seizure, the doctor may prescribe magnetic resonance imaging (MRI) or other tests to look for scarred areas in the brain. Electroencephalography (EEG) can help distinguish seizure disorders from other conditions.
If the doctor determines the person has a seizure disorder such as epilepsy, an individualized approach to treatment can help manage it. A range of therapies, including anti-seizure medication, nerve stimulation, dietary therapy and surgical procedures can address the seizures and, in many cases, bring them under control.
A seizure is the term given to the physical findings or changes in behaviour that occur after an episode of abnormal electrical activity in the brain.
Although usually linked to epilepsy, there are other conditions that can trigger a seizure, and there are also a number of different types of possible seizures.
The term ‘convulsion’ is also sometimes used as an alternative to seizure.
What symptoms do seizures cause?
These vary widely and some may even go unnoticed, or only cause mild symptoms such as staring spells.
The specific symptoms depend on what part of the brain is involved, but all occur suddenly.
Seizure symptoms include:
- Frothing at the mouth or making odd noises (such as grunting)
- A brief blackout followed by a period of confusion
- Abnormal eye movements
- Loss of bladder or bowel control
- Body shaking and muscle spasms that cannot be controlled with twitching and jerking limbs or falling
- Mood changes
- Teeth clenching or tongue biting
- Stopping breathing for a short time
Symptoms may stop after a few seconds or minutes, or continue for 10 to 15 minutes (they do not usually last longer than this).
There may also be warning symptoms before a seizure happens, such as feelings of nausea, fear or anxiety and visual symptoms such as flashing lights, spots or wavy lines before the eyes.
What are the causes of seizures?
Any type of seizure is caused by irregular or erratic, and sudden electrical activity in the brain.
The most common cause in the UK is epilepsy, but other possible causes include:
- A very high temperature (particularly in children under the age of 6)
- Abnormal levels of sodium or glucose in the blood Infections (including meningitis)
- Congenital brain defects and brain tumours
- Drug abuse or poisoning
- Head injuries
- Alcohol withdrawal.
Idiopathic seizure is the term given to a seizure in which no cause can be found.
Idiopathic seizures are most commonly seen in children and younger adults, but can occur at any age.
There is often also a family history of epilepsy or seizures in such cases.
What should I do if someone has a seizure?
It is important to know that most seizures will stop by themselves without any need for immediate treatment.
However, during a seizure, the person affected can be hurt or injured.
So, if a seizure occurs, the main aim is to protect that person from injury.
The best ways of doing this are to:
- Lay the person on the ground in a safe area, clear of furniture or sharp objects.
- Put a cushion under the person’s head and loosen any tight clothing, especially around the neck.
- Turn the person onto their side – this is so that if any vomiting occurs, the vomit is not inhaled into the lungs.
- Check to see if they are wearing any kind of Medic Alert bracelet or necklace with seizure instructions on it.
- Stay with the person until they recover, or until medical help arrives.
- Try to hold down the person.
- Place anything between the person’s teeth during a seizure (including your fingers).
- Move the person unless they are near something hazardous.
- Try to stop them convulsing. They have no control over the seizure and are not aware of what is happening at the time.
- Give them mouth-to-mouth resuscitation until the convulsions have stopped and the person is fully awake, alert and recovered.
- Begin CPR (cardiopulmonary resuscitation) unless the seizure has clearly stopped and the person is not breathing or has no pulse.
When should I call for medical help?
Call for help if this is the first time the person has had a seizure, or if the seizure lasts more than three to five minutes.
If the person does not come round properly, show normal behaviour after a seizure or if another seizure starts soon after a seizure ends then assistance should be sought
. If they have a seizure in water, or are pregnant, injured or has diabetes then help should also be called for.
In general, if you have concerns ask for help.
What happens after someone has a seizure?
If someone has a new or severe seizure, they are usually seen as an emergency in hospital, where doctors try to diagnose the type of seizure based on the symptoms and the history provided by witnesses.
Tests are usually done to rule out other medical conditions that cause seizures or similar symptoms, including fainting, transient ischemic attack (TIA) or stroke, panic attacks and migraine.
Tests that may be ordered include blood tests, a CT scan or MRI scan of the head, and an electroencephalogram (EEG).
Further testing may be needed in cases of a new seizure without a clear cause or in someone with previously well controlled epilepsy.
Other people also read:
Neck pain: Neck pain can be caused by inappropriate working posture.
Sleeping sickness: Sleeping sickness is also known as trypanosomiasis or African sleeping sickness.
First aid – what everybody should know: By performing simple procedures and following certain guidelines, it may be possible to save lives.
Last updated 23.07.2014
First Aid: Seizures
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Seizures are almost never life-threatening. Many last only a few minutes and stop on their own. Still, it can be alarming to see a child having a seizure, and it helps to know what to do.
Signs and Symptoms
Seizures can take many forms, from staring spells to involuntary movements of the arms and legs. Some signs a child might be having a seizure are:
- unusual sensations or twitching before the seizure
- staring, not responding to anyone
- uncontrollable muscle spasms
- loss of consciousness (passes out)
- uncontrolled peeing or pooping
What to Do if Your Child Has a Seizure:
If someone is nearby, ask them to call your child’s doctor. If no one is with you, follow the steps below and then call the doctor:
- Gently place your child on the floor or ground, and remove any nearby objects.
- Lay your child on his or her side to prevent choking on saliva (spit).
- If your child vomits, clear out the mouth gently with your finger.
- Loosen any clothing around the head or neck.
- Make sure your child is breathing OK.
- Don’t try to prevent your child from shaking — this will not stop the seizure and may make your child more uncomfortable.
- Don’t put anything in your child’s mouth. Your child will not swallow his or her tongue, and forcing teeth apart could cause injuries or block the airway.
- Don’t give your child anything to eat or drink, and don’t give any medicine pills or liquid by mouth until your child is completely awake and alert.
- Try to keep track of how long the seizure lasts.
- Your child may be sleepy or may take a while to get back to normal after the seizure. Stay with your child until he or she is awake and aware, and let your child rest after the seizure.
Get Emergency Medical Care or Call 911 if Your Child:
- has a seizure lasting more than 5 minutes or is having repeated seizures
- has trouble breathing
- has a bluish color on the lips, tongue, or face
- remains unconscious for more than a few minutes after a seizure
- falls or hits his or her head before or during a seizure
- seems to be sick
- has a seizure while in water
- has any symptom that concerns you
If your child has a known seizure condition, be sure that he or she gets plenty of rest and takes any prescribed seizure medicine on time.
Reviewed by: Kate M. Cronan, MD Date reviewed: July 2018
First aid quick guide
This guide is particularly relevant for tonic clonic seizures where the person shakes or jerks.
Although seizures can be frightening to see, they are not usually a medical emergency. Usually, once the seizure stops, the person recovers and their breathing goes back to normal.
How to help if someone is having a seizure
- Stay calm.
- Look around – is the person in a dangerous place? If not, don’t move them. Move objects like furniture away from them.
- Note the time the seizure starts.
- Stay with them. If they don’t collapse but seem blank or confused, gently guide them away from any danger. Speak quietly and calmly.
- Cushion their head with something soft if they have collapsed to the ground.
- Don’t hold them down.
- Don’t put anything in their mouth.
- Check the time again. If a seizure doesn’t stop after 5 minutes, call for an ambulance (dial 999).
- After the seizure has stopped, gently put them into the recovery position and check that their breathing is returning to normal. Gently check their mouth to see that nothing is blocking their airway such as food or false teeth. If their breathing sounds difficult after the seizure has stopped, call for an ambulance.
- Stay with them until they are fully recovered.
When to call 999
Usually, when a person has an epileptic seizure there is no need to call an ambulance. However, always dial 999 for an ambulance if any of the following apply:
- it is the person’s first seizure;
- they have injured themselves badly;
- they have trouble breathing after the seizure has stopped;
- one seizure immediately follows another with no recovery in between;
- the seizure lasts two minutes longer than is usual for them; or
- the seizure lasts for more than five minutes.
If you need to make a call to the emergency services on an Android or iPhone device, there are ways to automatically send your GPS location to the emergency services at the same time.
How to Help Someone Who’s Having a Seizure
Have you ever been out in a crowded place when suddenly, someone drops to the ground, shaking? Or maybe they just freeze, staring off into space and acting unresponsive for a minute or two?
What you’ve just witnessed is probably a seizure. And it can be hard in the moment to know how to help the person.
Around 3.4 million people in the United States have epilepsy, the most common cause of seizures, according to the Centers for Disease Control. For people who have epilepsy, seizures can happen with no particular triggers at all. Minor things can also trigger seizures, including sleep deprivation, illness, bright flashing lights, stress, low blood sugar or even hormonal changes.
But seizures can also happen to people who don’t have epilepsy. These are often precipitated by things such as a very high fever in a child, stroke, recreational drugs, heavy alcohol use or certain prescription medications.
One thing Dr. Shahin Hakimian, a UW Medicine neurologist who specializes in epilepsy, wants people to understand is that seizures are involuntary and the person having one is unlikely to cause you any harm. Just because they might be behaving oddly doesn’t mean they’re dangerous.
“I’ve had patients who were minorities who get police called on them because they were acting oddly in public. It’s important to have more empathy and awareness of that,” he says.
Here’s how to identify if someone is having a seizure, how to help and how to know if a seizure warrants calling 911.
How to know if someone’s having a seizure
Seizures are like electrical storms of the brain. There are many different types and each comes with a different set of symptoms.
“When people think about seizures, they think about convulsions, but seizures can come in different forms and different severities,” says Hakimian.
Sometimes they start on both sides of brain at once; these are called generalized onset seizures, and the symptoms and severity of them vary. Some generalized seizures are typical full-body shaking episodes called generalized tonic clonic seizures.
Other seizures may produce sudden irregular jerking of both sides of the body. These are called myoclonic seizures.
Additionally, there are milder seizures that are particularly common in younger children, where a person briefly stares and momentarily loses their train of thought. These are called absence or petit mal seizures.
Another type of seizure only starts in and involves one part of the brain. These are called focal onset seizures and may be less noticeable; people may twitch in only a few muscles, stare or appear confused.
Other signs of these seizures include disorientation, a glazed look in the eyes, trouble talking or talking nonsensically, or behavioral tics like tapping or lip smacking.
People can do anything they do regularly during a seizure — minus the awareness of their actions, Hakimian says.
“I’ve had patients who walked into traffic, a patient who woke up on his front lawn naked holding a candy bar, another patient who woke up in a bathtub at four in the morning. People can do really complex things,” he says.
There are also events known as nonepileptic seizures that can happen to people who don’t have epilepsy. These are caused by emotional or psychological distress. They’re more common in people who have psychiatric conditions.
The signs and symptoms of a nonepileptic seizure can look nearly identical to those of an epileptic seizure, however, and some people who experience nonepileptic seizures get erroneously diagnosed with epilepsy.
What to do — and not do — when someone’s seizing
Seizures can look dramatic, but most of the time the person isn’t in danger. It’s important to stay calm and try to help. Here’s what you can do.
Make sure they’re safe. If someone is standing or starting to fall when they start seizing, try to catch them or guide them to a place where they can lie down without hurting themselves. If they start twitching or convulsing, find something soft like a blanket or jacket to put under their head so they’re not banging it against the ground. For people who start seizing when they’re in water, it’s crucial to help them out of the water or stay afloat so they don’t drown.
Roll them on their side. It’s easier for someone to breathe on their side. Plus, if the person starts drooling or vomiting, which can sometimes happen, you don’t want them to choke.
Don’t restrain them. If someone convulses, you might be tempted to try to get them to stop, but this could end up hurting them (and possibly you). Don’t try to hold down someone who is moving.
Track symptoms. Often a person who has a seizure does not know what just happened. Keep track of what symptoms they experience so you can let them know. Your observations may be very useful information to have if the person does need to go to a hospital. It may help their doctor make the correct diagnosis, for example. It’s also good to check for any medical IDs they might be wearing that provide information about their condition.
Don’t put anything in their mouth. There’s a misconception that you should put something in a seizing person’s mouth so they don’t swallow their tongue. Not only is this untrue (people can’t swallow their tongues) but also it’s potentially harmful, as putting something in the mouth of someone who’s not conscious could cause them to choke.
Time it. Most seizures last only a minute or two. Keep an eye on the time to make sure the seizure isn’t lasting too long.
Talk to them. Some people might yell or seem angry during or right after a seizure. If this happens, talk to them quietly to calm them and reassure them that they’re safe. They could also be confused or disoriented, in which case a friendly voice is helpful. After they wake up, tell them what just happened and ask if they’ve had a seizure before and, if so, what they usually do after one happens.
When is a seizure an emergency?
If a seizure lasts longer than five minutes, it becomes a medical emergency. If someone has multiple seizures in a row, that’s also a reason to call 911.
Other reasons to seek medical help are if this is someone’s first seizure; if they have trouble or stop breathing; if they injure themselves during the seizure; of if they’re in a body of water and you can’t get to them to keep them from drowning.
It’s not necessary to automatically call 911 if you suspect someone is seizing. In fact, it’s better if you don’t. As long as the person’s seizure doesn’t last long, they’re coherent when they awaken from it and they’re breathing OK, they should be fine.
“For people who have chronic epilepsy, having a seizure is a normal part of their life. It can be disruptive and costly to go to the ER and have 911 called all the time,” Hakimian says.
It’s important to note that sometimes people can appear confused (or even drunk) after a seizure; this is called the postictal phase. Not everyone experiences it, but for those who do, it can last from several minutes to hours.
Aside from confusion, people in the postictal phase can be sleepy, anxious, dizzy or otherwise upset and can have symptoms like a headache, nausea or even trouble with bladder control. Most of the time, these symptoms are not severe enough to warrant a 911 call.
How to tell a seizure apart from another medical problem
Seizures are different from fainting spells, where the person has a sudden and brief loss of blood flow to the brain. When someone faints, there is usually an identifiable cause — maybe they saw blood, stood up too fast, or didn’t have enough to eat before exercising.
Sometimes, people twitch as they collapse during a fainting spell. Don’t mistake this for the much more noticeable convulsions that might happen during a seizure, Hakimian says.
Twitching can also occur in the first few seconds after someone loses blood flow to their brain because of something like a heart attack, which can sometimes make it hard to figure out what’s going on. In general, convulsions during a seizure will last much longer and be more noticeable, Hakimian says.
If someone collapses and turns pale or has trouble breathing for more than a few seconds, that’s not a seizure but a medical emergency like a heart attack or stroke. If a person does not recover immediately in these situations, you should initiate CPR and call 911 right away.
“It’s usually easy to distinguish these from a seizure,” Hakimian says.