Most people don’t understand that seizures can be serious. Some people think that seizures are never a problem (not true), while other people think that seizures are always dangerous (also not true). The truth lies somewhere in between.

Seizures can be serious. They can cause problems like injuries, brain damage, life-threatening emergencies, and even death.

This is a scary topic, but it’s important to get the facts so you know what questions to ask your doctor and health care team. They can help you understand your risks and learn ways to keep yourself safe.

What type of injuries can seizures cause?

It depends on the type of seizure, how long the seizure lasts, where you are when the seizure happens, and if the seizure develops into a life-threatening emergency. Some types of seizures rarely cause injury. For example, seizures that don’t affect a person’s awareness or movement are not likely to cause serious injuries. Seizures with loss of consciousness, change in awareness or falls are more likely to cause injuries. 

Some common injuries that can happen during a seizure are bruises, cuts, and burns. People can also get hurt if they fall during a seizure.

Certain types of seizures can cause more serious problems — like broken bones, concussions, head injuries with bleeding into the brain, or breathing problems. These serious problems are more likely for people who have generalized seizures with falls, long seizures, or many seizures (like clusters of seizures that happen one after the other).

Will a person with epilepsy die earlier than a person without epilepsy?

The overall risk of dying is 1.6 to 3 times higher for a person with epilepsy than for a person without epilepsy. The risk for children may be a bit higher, since most children without epilepsy have a very low risk of dying.

A person’s risk of dying depends on how often they have seizures, and how severe the seizures are.

Some conditions that cause epilepsy, like a stroke or a brain tumor, can also increase a person’s risk of dying. People with these problems may die sooner from the cause of the  seizures and not from the seizures themselves. 

  • On average, people with seizures that have no known cause die only 2 years earlier than would otherwise be expected.
  • On average, people with seizures that have a known cause die 10 years earlier than would otherwise be expected.

What are seizure emergencies?

Sometimes a seizure can turn into a life-threatening situation, or medical emergency. This is also called a “seizure emergency.”

A convulsive seizure is a medical emergency if it lasts 5 minutes or longer. This is called “tonic-clonic status epilepticus.” If the seizure can’t be stopped, or if repeated seizures happen one right after another, the person may die or have permanent injuries. If you have had long or repeated seizures before, talk to your care team about whether a resuce treatment could be used to prevent status epilepticus.

People with epilepsy can also die from inhaling (breathing in) vomit or other fluids during or after a seizure. That’s why it’s important to turn the person onto one side as soon as possible when a seizure starts. This lets saliva, vomit, and other fluids drain out of the mouth and not get into the lungs. Learn more about seizure first aid.

Other types of emergencies that can happen during a seizure include drowning or getting into an accident. People who are not seizure free need to take steps to prevent accidents during a seizure: 

  • Take showers instead of baths. If you have a seizure while you are taking a bath, you may die from drowning. Drowning can happen in a tub with only a few inches of water.
  • Talk to your doctor about whether it’s safe for you to drive. Your state or province may also have rules about whether it’s legal for you to drive.
  • Be careful on train or subway platforms and when walking near busy streets.

Despite the risks, it’s important to remember that people rarely die from seizures. With some planning, you should be able to lead an active and safe life. 

What is sudden unexpected death in epilepsy (SUDEP)?

SUDEP is the most common cause of death in people with epilepsy. SUDEP happens when a person with epilepsy who is in their usual state of health dies unexpectedly. The death is not related to an accident and an autopsy won’t find another cause of death.

Here are some facts about SUDEP:

  • It’s uncommon, but it’s a real risk that people need to be aware of.
  • It happens in about 1 in 1,000 people with epilepsy each year.
  • It happens more often in people with poorly controlled epilepsy. One of 150 people with uncontrolled seizures die of SUDEP each year. 

When SUDEP does happen, the person is often found dead in bed, and it may not look like they had a convulsive seizure. They are often found lying face down. About a third of the time, however, there is evidence that the person had a seizure close to when they died. 

No one is sure what causes SUDEP. Some researchers think that SUDEP happens when a seizure causes an irregular heart rhythm, breathing problems, or other problems in the brain or body.

Help is on the way. The Epilepsy Foundation has founded the SUDEP Institute. The Institute is working to:

  • Spread the word about sudden unexpected death in epilepsy
  • Help people learn how to lower their risk of SUDEP
  • Get help to people who have lost a loved one to SUDEP
  • Speed up research on what causes SUDEP and how we can prevent it
Authored By: 
Patty Obsorne Shafer RN, MN
Authored Date: 
Reviewed By: 
Joseph I. Sirven MD
Wednesday, October 15, 2014