A client with epilepsy is having a seizure. during the active seizure phase, the nurse should:

The three seizure phases are defined as:

Beginning phase

Prodrome stage

During the prodromal stage some people can tell when a seizure is on its way. They may notice some early signs hours or even days before the seizure starts. Not all people experience this stage. Some common signs can include: 

• Mood changes
• Anxiety
• Feeling lightheaded
• Difficulty sleeping
• Difficulty staying focused
• Behaviour changes.

Aura

Auras are generally considered an early part of the seizure. Symptoms of an aura may include: 

• Déjà vu (a sense that something has happened before when in fact it hasn’t)
• Jamais vu (a feeling that you’re seeing something you know well for the first time)
• Odd smells, sounds or tastes
• Dizziness
• Vision difficulties
• Numbness or ‘pins and needles’ in parts of the body
• Nausea
• Headache
• Panic
• Feelings of intense fear

Sometimes a person may have an aura which doesn’t progress to become a more severe or prolonged seizure. Some people don’t experience an aura at all, and their seizure has no early warning signs.

Middle (ictal) phase

The middle (ictal) stage of a seizure is called the ictal phase. It’s the time from the first symptom to the end of the seizure activity. It is during this time that intense electrical activity is occurring in the brain. Some common signs of this phase include:

• Loss of awareness
• Memory lapse
• Felling confused
• Difficulty hearing
• Odd smells, sounds or tastes
• Difficulty speaking or saying strange words
• Twitching
• Loss of muscle control
• Repeated movements (such as lip smacking or chewing)
• Body convulsions
• Racing heart
• Trouble breathing

Ending (post-ictal) phase

The final post-ictal stage occurs after the active (ictal) part of the seizure. This is the recovery stage and during this phase any physical after effects of the seizure are felt. The type of seizure and the part of the brain involved will determine how long it takes for a person to return to their usual self. 

Some common signs of this phase include:

• Confusion
• Lack of consciousness
• Tiredness (fatigue)
• Exhaustion
• Headache
• Loss of bladder or bowel control
• Fear and anxiety
• Frustration
• Shame or embarrassment
• Thirst
• Nausea
• Sore muscles
• Weakness in parts of the body
• Injury (head, cuts, broken bones)

Once the seizure is over, some people may remember having one, remember parts of it, or not remember at all.