---
title: "Epilepsy: Symptoms, Causes & NHS Treatment | HealthAnswers"
description: "Epilepsy and seizures — types, triggers, diagnosis, NHS anti-seizure medicines, and when to call 999."
url: https://healthanswers.co.uk/conditions/epilepsy/
robots: noindex
---

# Epilepsy: Symptoms, Causes & NHS Treatment | HealthAnswers

Health A–Z

Epilepsy and seizures — types, triggers, diagnosis, NHS anti-seizure medicines, and when to call 999.

Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026

## Quick answer

What is epilepsy? Epilepsy is tendency to have recurrent unprovoked seizures — sudden bursts of electrical activity in the brain causing convulsions, staring spells, or unusual sensations. One seizure does not always mean epilepsy — diagnosis usually requires two or more. Anti-seizure medicines control seizures in about 70% of people. Phone 999 for seizure lasting over 5 minutes, repeated seizures, or first seizure with injury or pregnancy.

## Who is this page for?

This page is for people in the UK who want a plain-English overview of Epilepsy, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally.

## Who should skip this page?

Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland.

On this page 8 sections

## Key facts about epilepsy

- Epilepsy affects about 1 in 100 people in the UK — can start at any age.
- Seizures may be convulsive (tonic-clonic) or non-convulsive — absence seizures cause brief staring in children.
- First seizure needs medical assessment — not all are epilepsy (fever, alcohol withdrawal, low sugar).
- Driving rules apply — must notify DVLA after unprovoked seizure — usually stop driving for 6 months.
- Status epilepticus — seizure over 5 minutes — medical emergency.

## Epilepsy — recurrent seizures explained

**Epilepsy** is diagnosed when a person has a **tendency to recurrent unprovoked seizures** — sudden **disruptive electrical discharges** in the brain.

**Seizure ≠ epilepsy** always — **one seizure** from **acute cause** (hypoglycaemia, hangover withdrawal, high fever in child) needs workup but may not label epilepsy.

UK prevalence: **~600,000 people** — **1 in 100**.

## What happens during a seizure

**Neurons fire abnormally** — synchronously — symptoms depend on **where** in brain and **spread**.

### Generalised tonic-clonic (grand mal)

- cry at start (air forced out)

- stiffening (tonic) then jerking (clonic)

- loss of consciousness

- ** tongue biting**, incontinence

- post-ictal confusion — minutes to hours

### Absence (petit mal) — mainly children

- brief blank stare — 5 to 10 seconds

- ** eyelid flutter**

- no post-ictal confusion — dozens daily possible — affects school

### Focal (partial) seizures

- aware or impaired awareness

- automatisms — lip smacking, picking clothes

- auras — déjà vu, strange smell, rising epigastric sensation

- may generalise to tonic-clonic

## Causes and triggers

**Structural:**

- stroke , tumour , head trauma , infection , ** cortical malformation**

**Genetic** — many **idiopathic** generalised epilepsies

**Triggers (in known epilepsy):**

- ** missed medicines** — commonest avoidable cause

- sleep deprivation

- alcohol excess and withdrawal

- flashing lights — photosensitive epilepsy (minority)

- menstruation (catamenial)

## First seizure assessment

**A&E or same-day GP:**

- glucose , electrolytes

- ECG if cardiac syncope suspected

- CT/MRI brain if indicated

- EEG — outpatient

- refer neurology

**Syncope vs seizure:**

- syncope — pale , brief jerks, rapid recovery

- seizure — cyanosis , prolonged confusion , tongue lateral bite

## Treatment

### Anti-seizure medications (ASMs)

**First-line depends on seizure type:**

- lamotrigine , levetiracetam , sodium valproate (not in women of childbearing potential without Pregnancy Prevention Programme)

- carbamazepine , phenytoin — focal

- ethosuximide — absence

**Monotherapy preferred** — add second if needed.

**70%** become **seizure-free** on first or second drug.

### Non-drug

- ketogenic diet — children, refractory adults — specialist

- surgery — resect focal lesion — curative potential

- VNS — vagus nerve stimulator

## First aid — tonic-clonic

**DO:**

- stay calm , time seizure

- protect head , move hazards

- recovery position when jerking stops

- 999 if >5 min or injury/pregnancy/first seizure

**DON’T:**

- restrain

- put objects in mouth

- give food/drink until fully alert

## Driving and lifestyle

**DVLA notification mandatory** — **6-month seizure-free rule** typical for Group 1.

**Swimming, heights, baths** — risk assessment.

**Sudden unexplained death in epilepsy (SUDEP)** — rare — **medicine adherence** reduces risk.

## Status epilepticus — emergency

**Seizure ≥5 minutes** or **cluster without recovery** — **999** — **benzodiazepines** (buccal midazolam, rectal diazepam) if rescue plan.

Epilepsy is **common, stigmatised, and treatable** — **one seizure needs neurology**, not assumption it will never recur.

## ! When to see a GP about epilepsy

After any first seizure or new seizure type — same day or A&E if not fully recovered. Neurology referral for diagnosis, EEG, MRI, and medicine choice. Phone 999 if seizure lasts over 5 minutes, another seizure starts before recovery, injury during seizure, difficulty breathing after, or seizure in pregnant woman. Wear medical ID if diagnosed.

## Common questions about epilepsy

What causes epilepsy? Often no identified cause — genetic predisposition common. Known causes include brain injury, stroke, tumour, infection, birth injury, and developmental malformations. A single seizure from alcohol withdrawal or high fever is not epilepsy — recurrent unprovoked seizures define epilepsy. What are the signs of a seizure? Tonic-clonic — body stiffens, jerking limbs, loss of consciousness, may bite tongue, incontinence, confusion after. Absence — brief blank stare, eyelid fluttering in children. Focal — strange smell, déjà vu, involuntary movement one body part — may spread. Not all seizures involve full convulsions. How is epilepsy diagnosed? Clinical history from witness essential — EEG records brain electrical activity — may be normal between seizures. MRI brain excludes structural cause. Diagnosis usually after two unprovoked seizures or one with high recurrence risk on EEG/MRI. Can epilepsy be cured? Medicines control seizures in about 70% — taken long term. Some become seizure-free and taper medicines under specialist supervision. Epilepsy surgery cures selected focal epilepsies. Vagus nerve stimulation and ketogenic diet for refractory cases — specialist centres. What should you do if someone has a seizure? Protect from injury — cushion head, clear space, do not restrain or put anything in mouth. Time seizure — call 999 if over 5 minutes or first known seizure with injury. After tonic-clonic ends, recovery position, stay until alert. Note time and features for doctor. Can you drive with epilepsy? Must notify DVLA after unprovoked seizure — Group 1 (car/motorcycle) usually cannot drive for 6 months seizure-free off medicines or 6 months on stable treatment depending on circumstances. Stricter for HGV/bus. Failure to notify invalidates insurance.

## Sources

- [NHS — Epilepsy](https://www.nhs.uk/conditions/epilepsy/)
- [NICE — Epilepsy](https://www.nice.org.uk/guidance/ng217)
- [Epilepsy Society](https://www.epilepsysociety.org.uk/)