Red Flags & When to Go In Person for Seizure (Suspected) - Triage

Audience: adult

If you or someone else experiences a suspected seizure, it is important to know when to seek immediate in-person medical care versus when telemedicine may be appropriate. Seizures can vary in severity and cause, and some require urgent evaluation to prevent complications. Telemedicine can help with initial assessment, follow-up, and guidance for managing known seizure disorders. However, certain warning signs or "red flags" mean you should go to an emergency department or call emergency services right away. These include seizures lasting longer than five minutes, repeated seizures without recovery, injury during a seizure, or new neurological symptoms. Early recognition and prompt care can improve outcomes. This guide helps you understand when telemedicine is suitable and when in-person care is needed for suspected seizures.

Red flags — go in person / ER

• Seizure lasting longer than 5 minutes — call emergency services immediately.
• Repeated seizures without regaining consciousness between episodes — seek urgent medical care.
• New or worsening neurological symptoms such as weakness, confusion, or difficulty breathing after a seizure — go to the emergency department promptly.

What telemedicine can do

• Initial assessment of seizure symptoms after the event if stable.
• Follow-up care for known seizure disorders.
• Medication management and adjustment discussions.
• Providing education on seizure safety and lifestyle modifications.

What telemedicine cannot do

• Seizures lasting longer than 5 minutes or multiple seizures without recovery.
• Seizures accompanied by difficulty breathing or turning blue.
• Seizure-related injuries requiring immediate evaluation.
• New onset seizures in adults needing urgent diagnostic testing.

What is a Suspected Seizure?

A seizure is a sudden, uncontrolled electrical disturbance in the brain that can cause changes in behavior, movements, feelings, or consciousness. A suspected seizure means someone has experienced symptoms that might be a seizure, such as convulsions, staring spells, or loss of awareness. Not all episodes are seizures, so medical evaluation is important.

When Telemedicine Can Help

Telemedicine may be appropriate for:

Telemedicine allows convenient access to healthcare professionals for guidance and follow-up.

Red Flags Requiring Immediate In-Person Care

Seek emergency medical care if any of the following occur:

These signs may indicate a medical emergency.

Preparing for a Telemedicine Visit

Before your tele-visit, prepare by:

Aftercare and Follow-Up

After a telemedicine consultation:

Proper follow-up helps manage seizures and reduces risks.

How to prepare for your tele-visit

• Write down a detailed description of the seizure event(s).
• List all current medications and any known medical conditions.
• Note any triggers, warning signs, or symptoms before the seizure.
• Have a family member or friend available to join or provide information if possible.
• Ensure a quiet, private space with a reliable internet connection for the tele-visit.

After your tele-visit

• Follow all instructions provided by your healthcare provider.
• Monitor for any new or worsening symptoms and seek emergency care if red flags appear.
• Keep a detailed seizure diary to track events and triggers.
• Schedule and attend follow-up appointments as recommended.
• Maintain medication adherence and report any side effects or concerns promptly.

FAQs

Can telemedicine diagnose a seizure?

Telemedicine can help healthcare providers assess symptoms and history to suggest whether an event might be a seizure. However, a definitive diagnosis often requires in-person evaluation, tests like EEG or imaging, and physical examination.

When should I go to the emergency room after a seizure?

Go to the emergency room if the seizure lasts more than 5 minutes, if there are repeated seizures without recovery, if there is difficulty breathing or injury, or if new neurological symptoms develop. These are medical emergencies.

Can telemedicine help manage epilepsy long-term?

Yes, telemedicine is often useful for ongoing management of epilepsy, including medication adjustments, monitoring side effects, and providing education and support.

What should I do if I witness someone having a seizure?

Stay calm and keep the person safe by moving harmful objects away. Do not restrain them or put anything in their mouth. Time the seizure and seek emergency help if it lasts longer than 5 minutes or if it is their first seizure.

Sources

1. Seizures — MedlinePlus, U.S. National Library of Medicine.
2. Epilepsy and Seizures — Centers for Disease Control and Prevention (CDC).
3. Seizures: First Aid — Mayo Clinic.
4. Seizure Disorders — Merck Manuals Consumer Version.

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical evaluation and care. If you experience any red flags or emergency symptoms, seek immediate medical attention.