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Epilepsy & Seizures

A seizure is a brief burst of unusual electrical activity in the brain; epilepsy means seizures keep coming back. Learn seizure first aid (Stay, Safe, Side), when to call 911, and how treatment helps most people live full lives.

Seizure first aid: Stay. Safe. Side. Stay with the person and time the seizure. Keep them safe: ease them to the ground, clear away hard objects and put something soft under the head. Turn them gently onto one side (CDC, Epilepsy Foundation). Put nothing in their mouth and don’t hold them down (CDC).

Call 911 if:

What is a seizure? What is epilepsy?

A seizure is a change in normal brain activity that lasts from a few seconds to a few minutes (CDC). Many nerve cells fire at once, much faster than normal, which can cause movements, feelings or behaviors the person can’t control, and sometimes a loss of awareness (NINDS). About 1 in 10 people in the U.S. may have a seizure in their lifetime (CDC), and one seizure does not by itself mean epilepsy (NINDS).

Epilepsy is a brain disorder that causes repeated seizures; it is not contagious (CDC). It is generally diagnosed after two or more unprovoked seizures at least 24 hours apart (NINDS). The International League Against Epilepsy (ILAE) defines it as any of: (1) at least two unprovoked (or reflex) seizures more than 24 hours apart; (2) one unprovoked (or reflex) seizure and a chance of further seizures over the next 10 years similar to the risk after two (at least 60 percent); or (3) a diagnosed epilepsy syndrome (ILAE official report, Epilepsia, 2014).

How common is it, and what causes it?

In 2021 and 2022, about 2.9 million U.S. adults — about 1 percent — reported active epilepsy, and about 456,000 children have it (CDC). About half of people with epilepsy don’t know the cause. Known causes include genes, differences in brain development, infections such as meningitis, head injury, stroke, brain tumors and Alzheimer’s disease (NINDS); our Head Trauma and Stroke guides are coming soon. Epilepsy is also common with cerebral palsy, autism and intellectual disabilities (NINDS) — see our guides to cerebral palsy, autism, Angelman syndrome and developmental disabilities.

Types of seizures

  • Focal seizures start in one area of the brain; about 60 percent of people with epilepsy have them. The person may stay aware but feel sudden emotions, déjà vu or nausea, or have one hand jerk; or their awareness may change and they may blink, make mouth movements or wander in a dreamlike state (NINDS). A focal seizure can spread into a tonic-clonic seizure (Epilepsy Foundation).
  • Generalized seizures involve both sides of the brain (NINDS). In a tonic-clonic seizure (once called “grand mal”) the person loses consciousness, falls, stiffens and then jerks, usually for 1 to 3 minutes, followed by confusion and tiredness (Epilepsy Foundation). An absence seizure is a brief blank stare, sometimes with rapid blinking, after which the person carries on; these usually begin in childhood and can happen many times a day, making it hard to concentrate at school (NINDS).

Most seizures look less dramatic than on TV: a person may simply seem confused, stare, wander or not answer questions (CDC).

Provoked seizures

Some seizures have a clear, immediate cause. If seizures keep happening after that problem is treated, the condition is called epilepsy (MedlinePlus).

Most single seizures are not followed by more, unless there is brain damage or a family history of epilepsy (NINDS).

Common triggers

Triggers don’t cause epilepsy but can bring on seizures in people who have it (NINDS). Common ones include lack of sleep, illness or fever, alcohol, drugs, stress, hormonal changes, skipped meals, flashing lights, and missed medicines (Epilepsy Foundation, CDC). Stress is the trigger people report most often (NINDS).

How epilepsy is diagnosed

A detailed history is one of the best tools, and because people rarely remember their seizures, a witness’s description is very important (NINDS) — a phone video helps too (Epilepsy Foundation). An EEG records brain activity; because it can look normal between seizures, some people wear a recorder for days or have video EEG in hospital. MRI or CT scans and blood tests look for a cause (MedlinePlus).

Look-alikes. Fainting — a brief blackout from a drop in blood flow to the brain (MedlinePlus) — as well as mini-strokes, panic attacks, migraines and sleep problems can resemble seizures (MedlinePlus). Functional seizures, also called psychogenic nonepileptic seizures (PNES), look like epileptic seizures but are not caused by abnormal electrical signals in the brain; seizure medicines don’t help them (NINDS). Video EEG is the most reliable test (Epilepsy Foundation), and cognitive behavioral therapy is often used to treat them (NINDS).

SUDEP: rare, and you can lower the risk

Sudden unexpected death in epilepsy (SUDEP) is a death in someone with epilepsy that is not caused by injury, drowning or another known cause. It is rare: each year about 1 in 1,000 U.S. adults with epilepsy, and about 1 in 4,500 children, may die from it. Most cases happen with a generalized seizure during sleep, and the main risk factors are generalized seizures and seizures that are frequent or uncontrolled (CDC). Taking seizure medicine as prescribed is the most important thing you can do; also avoid triggers, get enough sleep, teach the adults at home seizure first aid, and ask your doctor about your own risk (CDC, Epilepsy Foundation).

Never stop a seizure medicine suddenly. It can cause withdrawal and life-threatening seizures (CDC). Talk with your doctor before taking any new medicine, vitamin or supplement (MedlinePlus). Free help, 24/7: the Epilepsy & Seizures Helpline, 1-800-332-1000 (Spanish: 1-866-748-8008) (CDC).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Diagnosis with history, witness accounts or video, EEG and MRI; antiseizure medicines; rescue medicines for long or clustered seizures; for drug-resistant epilepsy, an epilepsy-center evaluation for surgery, VNS, RNS or DBS devices, and ketogenic or modified Atkins diet therapy; FDA-approved cannabidiol for three rare syndromes. Cost estimate being researched. CDC reports that adults with epilepsy are more likely than others to skip medicine to save money; the 24/7 Epilepsy & Seizures Helpline is free. Medicines work for about 2 in 3 people with epilepsy. Finding the right medicine can take months. Never stop a seizure medicine suddenly.
Chiropractic We found no controlled trials of chiropractic care for epilepsy — only case reports. Not applicable. Not a treatment for epilepsy. If you see a chiropractor for back or neck pain, tell them about your seizures and keep taking your medicines.
Acupuncture A Cochrane review of 17 small trials found the evidence does not support acupuncture for treating epilepsy. About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. Unproven for seizure control. Never use it in place of seizure medicines.
Herbal medicine No herb has been proven safe and effective for epilepsy. Some herbs can make seizures more likely or interfere with seizure medicines. Not applicable. Avoid ginkgo, evening primrose and St. John’s wort unless your neurologist agrees. Store-bought CBD is not the same as the FDA-approved prescription.
Massage therapy Relaxation and stress relief; stress is the trigger people with epilepsy report most often. About $60–$120 for 45–60 minutes with a private therapist, or $50–$90 at clinics and spas. May help you relax; it is not a seizure treatment. Skip essential oils such as rosemary, sage and eucalyptus, and tell your therapist what to do if you have a seizure.
MBHA Wellness Coach Daily habits that lower seizure risk: regular sleep, medicine routines and pill organizers, a trigger diary, alcohol and stress, home and water safety, a seizure action plan for school and work, and mood support. Cost estimate being researched. Seizure action plan forms can be downloaded from the Epilepsy Foundation, and the 24/7 Helpline is free. Supports — never replaces — your neurologist and care team.

Approach 1 of 6

Conventional medicine (AMA)

Once epilepsy is diagnosed, treatment should start as soon as possible (NINDS). See a neurologist or an epileptologist (a neurologist who specializes in epilepsy) if seizures aren’t controlled or side effects are hard to live with (CDC). We name treatments but never doses — your team will tailor them.

1. Antiseizure medicines

2. Rescue medicines

For seizures that last too long or come in clusters, doctors may prescribe a rescue medicine. Most are fast-acting benzodiazepines, in forms sprayed into the nose, placed under the tongue or inside the cheek, or given rectally. Patients and caregivers should be trained in when and how to give them, and the instructions should go in a seizure action plan (Epilepsy Foundation).

3. When medicines don’t work

Seizure medicines fail to control seizures, or cause bothersome side effects, in at least 3 in 10 people (Epilepsy Foundation). Epilepsy that doesn’t improve after two or three medicines is called drug-resistant (medically refractory) (MedlinePlus), and an epilepsy center can review other options (CDC).

  • Surgery is usually considered after at least two medicines have failed. When medicines fail, surgery is much more likely to make someone seizure-free than trying more medicines, but it carries risks and should be assessed at an experienced epilepsy center (NINDS).
  • Devices: vagus nerve stimulation (VNS) uses a device under the skin of the chest connected to a nerve in the neck; responsive neurostimulation (RNS) detects a seizure starting and responds; and deep brain stimulation (DBS) stimulates specific areas of the brain (NINDS).
  • Dietary therapy, usually alongside medicines, includes the high-fat, low-carbohydrate ketogenic diet and the less strict modified Atkins diet (Epilepsy Foundation). The ketogenic diet is prescribed by a doctor and monitored by a dietitian (CDC). In studies of the modified Atkins diet, about half of patients had at least 50 percent fewer seizures after six months; it should be done only with physician supervision (Epilepsy Foundation).

4. Prescription cannabidiol (CBD)

The FDA has approved one CBD medicine, Epidiolex, for seizures linked to three rare conditions: Lennox-Gastaut syndrome, Dravet syndrome and tuberous sclerosis complex. Store-bought and online CBD products are different: they have not been evaluated for whether they work, the right dose, drug interactions or safety (FDA). FDA testing found many didn’t contain the amount of CBD they claimed, and CBD can cause liver injury and interact with other medicines (FDA). There isn’t enough research on cannabinoids for more common forms of epilepsy (NCCIH).

5. Pregnancy and seizure medicines

With the right medicine choices, folic acid and ideally planning before pregnancy, most people with epilepsy have healthy pregnancies and babies. Some seizure medicines raise the risk of birth defects, so plan with a neurologist and an obstetrician (NINDS). Tell your provider before you try to become pregnant so medicines can be adjusted — and talk to your doctor before stopping or changing any medicine (MedlinePlus).

What it costs

Cost estimate being researched. CDC reports that adults with epilepsy are more likely than others to be unable to afford medicine or specialist care, or to skip doses to save money (CDC). If cost is a problem, tell your doctor and ask about discount programs from pharmacies, drug companies, nonprofits and states (NIA).

What to expect

Many people who respond to treatment go months or years without a seizure and live full, productive lives (NINDS). Some childhood epilepsies improve with age; for others, epilepsy is lifelong and medicine continues (MedlinePlus).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

There is no good evidence that chiropractic care treats epilepsy. Our PubMed search in October 2026 for chiropractic and epilepsy or seizures returned 17 records, and none was a controlled trial: they were individual case reports, surveys of how often people use it, and a 2001 review in a chiropractic journal that gathered 17 case reports and described the evidence as anecdotal (literature review, J Manipulative Physiol Ther, 2001). Case reports alone can’t show whether a treatment works. The Epilepsy Foundation lists chiropractic among mind and body practices and advises discussing any change to your treatment plan with your doctor (Epilepsy Foundation).

Safety

  • Tell your chiropractor that you have epilepsy, what your seizures look like and what to do if one happens during a visit — a copy of your seizure action plan helps (Epilepsy Foundation).
  • Strong muscle contractions during a tonic-clonic seizure can occasionally injure the spine; one report describes a man with new epilepsy whose back pain after a seizure turned out to be five spinal compression fractures. The authors stress a full history and exam before spinal adjustments (case report, J Can Chiropr Assoc, 2016). Severe back pain after a seizure needs a doctor (Epilepsy Foundation).
  • Mild, short-lived soreness, stiffness or headache often follow spinal manipulation. Serious problems, such as strokes from tears in neck arteries, are very rare, and the risk may be greater in people with underlying health problems (NCCIH). Never stop seizure medicines because of advice from anyone other than your prescriber.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is used by some people with epilepsy, but the research does not show it controls seizures.

What the research says

  • A 2014 Cochrane review — the most rigorous kind of summary — included 17 randomized trials with 1,538 people. All had a high risk of bias and short follow-up. The authors concluded that the trials were small and varied, and that current evidence does not support acupuncture for treating epilepsy (Cochrane review, 2014).
  • Some comparisons hinted at fewer seizures or better quality of life, but these came from small trials with a high risk of bias (Cochrane review, 2014).
  • The Epilepsy Society says there is no evidence that acupuncture directly helps epilepsy, though it may help some people with anxiety (Epilepsy Society).

Safety

In the trials, acupuncture did not cause more side effects than the comparison treatments (Cochrane review, 2014). Relatively few complications have been reported; problems have come from nonsterile needles and improper treatment, and in the U.S. needles must be sterile and single-use (NCCIH). Tell the acupuncturist about your seizures in case one happens with needles in place, and keep taking your seizure medicines.

What it costs

Published examples run about $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics charge about $50–$90. Insurance coverage varies (The Pricer).

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Approach 4 of 6

Herbal medicine

No herbal remedy has been proven safe and effective for epilepsy, and some can make seizures worse, either by causing seizures or by interacting with seizure medicines. “Natural” does not mean safe for people with epilepsy (Epilepsy Foundation).

Never swap an herbal product for a prescribed seizure medicine. Doing so can lead to life-threatening prolonged seizures (status epilepticus). Take all your bottles to every doctor visit (Epilepsy Foundation).

Herbs and supplements to be careful with

  • Ginkgo: can increase the risk of seizures; talk with your provider if you have a history of seizures. It may also make midazolam, a medicine used for seizures, less effective (Memorial Sloan Kettering).
  • St. John’s wort: can weaken the effects of many medicines, including some seizure medicines such as phenytoin and carbamazepine (NCCIH). It has a high overall risk of drug interactions, including with benzodiazepines (NCCIH), the group most rescue medicines belong to.
  • Evening primrose: Mayo Clinic advises people with epilepsy not to take it, because it might raise the risk of seizures (Mayo Clinic).
  • CBD products sold in stores or online are not the FDA-approved prescription and can interact with other medicines (see the conventional medicine section) (FDA).

Many herbs may raise seizure risk, and herb-drug interactions can be hard to predict because the amount of active ingredient is often unknown (review, Epilepsia, 2008). Check with your doctor before taking any other medicine or supplement (CDC), tell any herbalist about all your medicines, and call your doctor about any new side effect (Epilepsy Foundation). We don’t list doses here.

Approach 5 of 6

Massage therapy

Massage won’t stop seizures, but it may help with something that matters: stress. In surveys, stress is the trigger people with epilepsy report most often (NINDS), and the Epilepsy Foundation suggests finding ways to manage it (Epilepsy Foundation). Massage is one relaxation option. The Epilepsy Society, a UK charity, says massage can generally be safe and even helpful for people with epilepsy, though stress, over-stimulation or other factors during a session could trigger a seizure (Epilepsy Society). We found little research on massage specifically for epilepsy.

Safety

  • The risk of harm from massage appears to be low, though rare serious side effects such as a blood clot, nerve injury or bone fracture have been reported (NCCIH).
  • Tell your therapist about your seizures and give them your seizure action plan (Epilepsy Foundation), so they know to stay with you, time a seizure, turn you on your side and never put anything in your mouth (CDC).
  • Essential oils: some may trigger seizures. The Epilepsy Society advises people with epilepsy not to use rosemary, fennel, sage, eucalyptus, hyssop, wormwood, camphor or spike lavender oils, and to ask a doctor, pharmacist or qualified aromatherapist before using oils bought over the counter or online (Epilepsy Society). Ask for plain, unscented oil if you aren’t sure.

What it costs

Private therapists charge about $60–$120 for 45–60 minutes; clinics, gyms and spas about $50–$90 (CostHelper).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Taking care of yourself can help control seizures (CDC). An MBHA Wellness Coach can help with the everyday side of epilepsy — alongside, never instead of, your neurologist.

Mood matters

Depression is common in people with epilepsy, and depression and anxiety are the two most common mental health diagnoses in adults with epilepsy; both can be treated (NINDS). Adults with active epilepsy were three times as likely to report depression in the past year as adults without it, and some seizure medicines can affect mood (Epilepsy Foundation). Tell your care team about mood changes, and see our guides to depression and anxiety. If you are thinking about suicide, call or text 988 (CDC, 988 Lifeline).

Another approach

Seizure first aid: Stay, Safe, Side

Most seizures end on their own within a few minutes (CDC).

  1. Stay with the person, stay calm and time the seizure (CDC).
  2. Safe: ease them to the floor, move hard or sharp objects away, put something soft under the head, remove glasses and loosen tight collars. Check for a medical bracelet (CDC).
  3. Side: gently roll them onto one side, mouth toward the ground, to keep the airway clear (CDC, Epilepsy Foundation).

Do not put anything in their mouth — a person can’t swallow their tongue, and objects can hurt teeth or the jaw or cause choking (CDC, Epilepsy Foundation); hold them down; give mouth-to-mouth during the seizure, since breathing usually restarts on its own; or give food, water or pills until they are fully alert (CDC).

Afterward, stay until they are fully alert, comfort them and explain what happened (CDC). If they have a rescue medicine or a VNS magnet, follow their seizure action plan (Epilepsy Foundation). In water, keep the face above the surface, get them out, start CPR if they aren’t breathing and call an ambulance even if they seem fine (Epilepsy Foundation). For when to call 911, see the alert at the top of this page.

Another approach

Febrile seizures in young children

A febrile seizure is a seizure caused by a fever in an otherwise healthy young child, often with a cold, flu or ear infection. Children aged 6 months to 5 years are most at risk, especially ages 1 to 3. A febrile seizure does not mean a child has epilepsy (NINDS).

  • Simple febrile seizures, the most common kind, last up to 15 minutes and happen once in 24 hours; complex ones last longer, repeat within 24 hours or affect only one part of the body (NINDS).
  • Simple febrile seizures are frightening but harmless: there is no evidence they cause brain damage, epilepsy or learning problems, and most children outgrow them by age 5 (MedlinePlus).
  • What to do: note the time, lay your child on their side on the floor, and don’t hold them down or put anything in their mouth. Call 911 if it lasts more than 5 minutes or your child isn’t recovering quickly. After a first febrile seizure, get medical care to find the cause of the fever — urgently if there is a stiff neck, extreme sleepiness, breathing trouble or a lot of vomiting (NINDS).
  • Fever medicines may make a child comfortable but don’t prevent febrile seizures (NINDS); ask the doctor before giving any medicine (MedlinePlus). Up-to-date vaccines may prevent some febrile seizures (NINDS).

Another approach

Living with epilepsy: driving, work and safety

Driving

Driving rules vary by state. Most states require a period without seizures before issuing a license, ranging from a few months to over a year (CDC), and the doctor usually fills out a form; some states allow restricted licenses, for example when seizures happen only during sleep (Epilepsy Foundation). Check your state in the Epilepsy Foundation’s driving laws database (Epilepsy Foundation). California is one of the states that require doctors to report people with active epilepsy to the DMV. If a seizure affects your awareness or control, stop driving and talk to your doctor; driving against medical advice or without telling the DMV can make you liable for an accident (Epilepsy Foundation).

Work, school and sports

By law, people with epilepsy in the U.S. cannot be denied a job or education because of it. Students may need extra time or a special education plan, and teachers should know seizure first aid (NINDS). Free online seizure training is available for school staff (CDC). Exercise may reduce seizure risk; wear a helmet for biking (CDC), avoid dehydration, overexertion and low blood sugar, and ask your doctor which activities are safest (NINDS).

Member stories

Living with Epilepsy & Seizures? Share your experience

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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