Epilepsy is a disorder characterized by changes in the electrical activity of the brain that cause a fit (seizure). The symptoms of an epileptic attack depend on the location, spread and intensity of these electric changes. A major (grand mal) epileptic fit usually starts with the sufferer losing consciousness and becoming completely rigid, which causes him or her to fall to the ground. An involuntary grunt or cry may be uttered and the sufferer may accidentally bite his or her tongue as the jaw muscles contract. Breathing stops, the lips turn blue, and saliva may dribble from the mouth. Control of the bladder and occasionally of the bowel may be lost. This rigid phase lasts for up to a minute, after which breathing resumes, and the limbs and body make jerking movements for several minutes. After the fit stops, the sufferer remains unconscious, sometimes for as long as a quarter of an hour, and may feel confused when he or she finally comes round.

If someone has an epileptic fit while you are there, keep calm. The best you can do is to try to break his fall and stop him injuring himself on furniture or other hard objects. Do not try to move the casualty unless he is in danger, and never try to force anything into the mouth. Once the fit has stopped, place the casualty in the recovery position until fully conscious, reassuring him as you do so. Particularly if unconsciousness lasted for a long time, arrange for the casualty’s transfer to hospital.