Normal Seizure Duration
Most normal seizures typically last between 1 to 2 minutes and resolve spontaneously without intervention. 1
Types and Duration of Seizures
Seizures are uncontrolled electrical discharges of neurons in the brain that can present in various forms:
Generalized tonic-clonic seizures: Affect large areas or both sides of the brain
- Manifest as full-body rhythmic jerking with altered consciousness
- Typically self-terminate within 1-2 minutes 1
Focal seizures: Affect only one area of the brain
- Present as jerking of one extremity/side, abnormal facial movements, repetitive movements, or staring spells
- May progress to generalized seizures
- Duration can vary but typically shorter than generalized seizures
When Seizures Become Abnormal
A seizure is considered abnormal or potentially dangerous when:
- Duration exceeds 5 minutes 1
- Multiple seizures occur without return to baseline consciousness between episodes 1
- Post-ictal state lasts longer than 5-10 minutes 1
Status Epilepticus
Seizures lasting more than 5 minutes may represent status epilepticus, a medical emergency requiring immediate intervention:
- Traditional definition: Seizure activity lasting ≥30 minutes or recurrent seizures without recovery of consciousness between episodes 2
- Current clinical practice: Any seizure lasting >5 minutes is now treated as potential status epilepticus 2
- Mortality risk: Status epilepticus has a mortality rate of 5-22%, which can increase to 65% in cases refractory to first-line therapies 1
When to Activate Emergency Medical Services
First aid providers should activate EMS for individuals with:
- First-time seizure
- Seizures lasting >5 minutes
- Multiple seizures without return to baseline mental status between episodes
- Seizures occurring in water
- Seizures with traumatic injuries, difficulty breathing, or choking
- Seizure in an infant <6 months of age
- Seizure in pregnant individuals
- Failure to return to baseline within 5-10 minutes after seizure activity has stopped 1
First Aid for Seizures
During a seizure:
- Help the person to the ground
- Place them on their side in the recovery position
- Clear the area around them to prevent injury
- Stay with the person throughout the seizure 1
Important Cautions
- Do not restrain the person having a seizure 1
- Do not put anything in the mouth of someone having a seizure 1
- Do not give food, liquids, or oral medicines during a seizure or when the person has decreased responsiveness 1
Special Considerations
- In children with febrile seizures, antipyretics (acetaminophen, ibuprofen) are not effective for stopping or preventing seizures 1
- Prolonged seizures (>180 seconds) during therapeutic procedures like ECT require medical intervention 1
Understanding the typical duration of seizures helps distinguish between normal seizure activity and emergencies requiring immediate medical attention. While most seizures self-terminate within 1-2 minutes, any seizure lasting more than 5 minutes should be considered a medical emergency.