Is it possible to die from a seizure?

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Seizures can be fatal, but dying from a seizure is uncommon. Epilepsy is a group of conditions in which people have seizures. However, a person without epilepsy can also have a seizure.

Many seizure deaths come from external factors like drowning, falling, or choking that occur during a seizure.

Sudden unexplained death in epilepsy (SUDEP) occurs when a person dies during or immediately after a sustained seizure with no other reason than the seizure.

SUDEP is rare and may only happen in 1.16 out of every 1,000 people with epilepsy, according to the CDC.

One study says SUDEP makes up about 7–17% of deaths among people with epilepsy. The researchers note the reported number of deaths can vary widely between studies.

Deaths from seizures that are not classified as SUDEP can come from a variety of factors, including:

• falling
• inhaling vomit
• drowning, even in a few inches of water, like a bath
• concussions, head injuries, or brain bleeding
• breathing issues

While the cause of sudden and unexplained death, or SUDEP, is by definition unknown, there are theories to suggest why death occurs. A pause in breathing could reduce oxygen in the brain or blood in a life-threatening way.

A convulsion might obstruct a person’s airway, leading to suffocation.

Other possibilities center around the heart. Some experts theorize that a heart arrhythmia or cardiac arrest might lead to death in SUDEP. It is possible SUDEP could also occur from a combination of cardiac and breathing factors.

The main risk for SUDEP is having frequent, uncontrolled, and intense seizures. SUDEP also more commonly occurs with convulsive seizures called tonic-clonic seizures (previously known as Grand Mal) compared with other seizures.

Risk factors for SUDEP include:

• if a person begins to have seizures at a young age
• many years of living with epilepsy
• missed medication
• drinking alcohol
• tending to have seizures at night

While many risks are out of a person’s control, there are a few things someone with seizures can do to reduce the chance of death.

Specifically for SUDEP, the most important thing is to make sure to take prescribed seizure medication. Other ways to avoid SUDEP include:

• Avoiding known seizure triggers, like flashing lights.
• Avoiding drinking alcohol.
• Getting enough sleep.
• Understanding how to control and manage seizures when they happen.

To help prevent injury or death for all seizures, consider making changes to increase the safety of the environment around someone with seizures.

Safety precautions may include:

• Padding sharp corners on desks and tables.
• Using nonslip carpets.
• Putting barriers in front of fireplaces and stoves.
• Fall-proofing the home by avoiding glass tables, and considering wearing a protective helmet.

Practicing water safety is an important way to protect someone with seizures from death by drowning. It is possible to drown in only a few inches of water.

To stay safe in the water:

• Make sure there is a lifeguard or someone with lifesaving training around when the person is swimming.
• Use the buddy system while in the water.
• Wear a life jacket.
• Take showers instead of baths if seizures are frequent.
• Use a shower chair.

Make sure a doctor knows about all the seizure events in a person’s life so they can suggest appropriate treatment.

A person with seizures should give a doctor information about seizure timing, duration, and frequency, and after what events seizures occur.

Some people keep a seizure journal to note information about what was happening at the time a seizure occurred, including time of day, alcohol or caffeine consumption, mood, sleep status, and other factors.

A person should ask their doctor:

• Does the doctor see any patterns in the person’s history of seizures?
• Can they recommend general safety tips?
• What environmental factors should they consider?
• Does the person need treatment, and could their life be better with it?
• What are the treatment options? What are the side effects?
• Should the person be living with someone?
• Should they invest in a seizure alert device?
• Should they see an epileptologist? This is a neurologist that focuses exclusively on treating epilepsy.

If a person has a seizure for the first time, they should see a doctor immediately to receive a diagnosis. Once a doctor has come up with a diagnosis and a treatment plan, the person should consistently check in.

If seizures become more severe, more frequent, or change in any way, a person should talk to their doctor again.

If a person wants to go off their seizure medication, they should also check in with their doctor to discuss the benefits and risks.

Dying from seizures is rare.

While there is not much a person can do to prevent SUDEP, except to continue their medication, there are ways of reducing the risk of accidental death during a seizure.

Making a person’s environment and behavior as safe as possible can help prevent death by drowning, falling, or choking during a seizure.

Living with someone or using the buddy system during water activities are other ways to reduce risk when living with seizures.