EmergencyEmergency Guide
Seizures: Red Flags & Emergency Signs
A prolonged seizure (>5 minutes) is status epilepticus — a neurological emergency with 20% mortality if untreated; first-ever seizures also require emergency evaluation to exclude brain pathology.
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If you have this symptom right now
Call 999 (UK) / 112 (EU) / 911 (US) immediately if any emergency warning signs are present. Do not drive yourself. Do not wait to see if it improves.
🚨 Call 999 / 112 Immediately
- ⚠Seizure lasting more than 5 minutes — status epilepticus, call 999 immediately
- ⚠Seizure in a pregnant woman (eclampsia until proven otherwise)
- ⚠Seizure in a patient with fever and neck stiffness — bacterial meningitis or encephalitis
- ⚠Seizure with no recovery of consciousness between episodes
- ⚠First-ever seizure in an adult — brain tumour, abscess, or haemorrhage must be excluded
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- •Post-ictal confusion lasting >30 minutes
- •Seizure with focal onset (twitching of one limb) — focal brain lesion
- •Seizure in a patient with known alcohol excess (withdrawal seizure)
- •Seizure in a diabetic — hypoglycaemia
High-Risk Combinations
When seizures occurs together with any of these symptoms, urgency increases significantly:
Conditions to Rule Out Urgently
Bacterial Meningitisemergency
LP after CT; IV antibiotics within 1 hour
Viral Encephalitis (HSV)emergency
EEG + MRI + LP; empirical IV aciclovir
Eclampsiaemergency
IV magnesium sulphate; urgent delivery if viable
Hypoglycaemiaemergency
BG immediately; dextrose IV
Brain Tumoururgent
MRI with gadolinium; neurosurgery referral
Condition Authority Pages
Differential diagnosis analyses:
When to Call Emergency Services
- →Seizure lasting more than 5 minutes
- →Seizure in a pregnant woman
- →No recovery of consciousness after seizure stops
- →First-ever seizure in any adult