Managing Seizures at Work

The best time to deal with a seizure at work is before it happens. Not because you can prevent it — but because preparation changes everything about how it goes.

A seizure action plan is a short document you create that tells the people around you: what your seizures look like, what to do, what not to do, and when to call 911. You can share it with your manager, a trusted coworker, or your whole team — your choice.

Why this matters more than almost any other accommodation: when people don't know what's happening, they panic. They call 911 for a seizure that ends in two minutes. They try to hold you down. They put something in your mouth — over half of healthcare workers in one study said they'd do this, so your office coworkers are even less likely to know better. They crowd around. And then afterward, they're scared — of you, of the situation, of it happening again. That's where most workplace problems start.

When people have a plan, they follow it. The seizure is still hard. But the response is calm, the aftermath is dignified, and you don't have to start from scratch rebuilding trust.

The evidence for SAPs is strong in clinical and school settings — patients with personalized plans received first medication faster and had shorter seizure durations. The Job Accommodation Network recommends a "plan of action" as a core workplace accommodation, essentially the same concept applied to work. Workplace-specific outcome data doesn't exist yet, but the logic is direct and the practical recommendation is consistent across every major guidance source.

This section is written for both audiences: you (to share with others) and the people around you (if they land here directly).

For most seizures

• Stay with the person. Don't leave them alone.
• Time the seizure. This matters more than anything else you do.
• Clear the area of anything that could cause injury. Move sharp objects, not the person.
• Cushion their head if they're on the ground.
• Turn them on their side if possible (recovery position).
• Do NOT restrain them. Do NOT put anything in their mouth.
• Talk calmly when it's over. They'll be confused. Tell them they're safe and you're there.

Call 911 if

• The seizure lasts longer than 5 minutes
• They have trouble breathing afterward
• They're injured
• It's their first known seizure
• Another seizure starts before they've recovered from the first

For seizures that don't look like what you'd expect

Not all seizures involve falling and convulsions. Some look like staring spells, confusion, repetitive movements, or brief lapses in awareness. If someone's seizure action plan describes these, follow the plan. If there's no plan, stay nearby, don't interfere, and check in when it passes.

One finding worth noting: research suggests that demonstrating proper seizure response — actually showing people what to do — may be more effective at reducing stigma than information alone. If you're training coworkers, show them. Don't just tell them.

The postictal period — the time after a seizure ends — is when you're most vulnerable, both physically and professionally.

What's happening physically: Confusion, exhaustion, headache, difficulty speaking, emotional distress. For most seizures, these effects last minutes to hours. After generalized tonic-clonic seizures, cognitive effects can be more prolonged. The range is wide — which is exactly why an individualized seizure action plan matters.

What the person needs:

• A quiet, private space to recover
• Time — don't rush them back to their desk
• Someone nearby (but not hovering)
• No food or water until they're fully alert
• Permission to go home if they need to — without it being treated as a performance issue

What often goes wrong: Well-meaning coworkers crowd around. Someone calls an ambulance when it wasn't needed. People ask detailed questions before the person can think clearly. The manager starts a conversation about "whether this is going to be a problem." All of this happens because nobody had a plan.

The seizure is over. The physical recovery is underway. Now comes the professional recovery.

Day of

• If you went home, send a brief message to your manager: "I'm recovering and expect to be back [tomorrow / date]. I'll follow up on [anything urgent]." You don't owe a medical play-by-play.
• If you stayed at work, give yourself permission to do lower-intensity work for the rest of the day. Your brain just went through something. Detailed decision-making and complex work can wait.

Day after

• Check in with your manager briefly. "I'm fine, thanks for [however they helped]. I have a seizure action plan if it would be helpful to have on file." This frames it as managed, not alarming.
• If coworkers are acting differently — overly cautious, avoidant, or weirdly cheerful — that's normal. It usually passes. If it doesn't, that's a conversation you can have on your terms.
• Document anything that concerns you: comments, changed behavior, shifted responsibilities. You may never need this documentation. But if you do, contemporaneous notes are the strongest evidence.

If your seizure was public

This is harder. The narrative exists whether you address it or not. You get to decide how much to say and to whom. A simple, confident statement works: "I have a medical condition that's well-managed. I appreciate everyone's concern. I'm fine." You don't owe details. You do owe yourself the dignity of addressing it rather than pretending it didn't happen.

You shouldn't have to be your workplace's epilepsy educator. But the reality is: if you don't give people something to work with, they'll fill the gap with whatever they think they know — which is usually wrong.

Options, from least to most involved:

Share your seizure action plan. One page. Covers everything they need. You can hand it to your manager and ask them to share relevant parts with the team. This is the minimum viable education.

A brief conversation. "Hey, I want to give you a heads-up about something. I have epilepsy. If you ever see me [describe what your seizures look like], here's what to do: [instructions]. It's usually over in a couple minutes. The main thing is don't panic." This works well with small teams or trusted coworkers.

A team training (usually through HR). General seizure first-aid training without disclosing that it's about you specifically. The EEOC allows this — employers can provide general disability awareness training without violating anyone's medical confidentiality.

The research on whether coworker education produces lasting attitude change is still developing. Short-term improvements in knowledge and attitudes are consistently demonstrated; lasting stigma reduction is not yet confirmed. What we believe based on experience: familiarity reduces fear, and having a plan in place improves response quality. Whether that translates to permanently changed workplace culture is an open question we think is worth pursuing.

Some jobs have legitimate safety considerations: operating heavy machinery, working at heights, driving as a primary function, certain healthcare roles. This doesn't mean people with epilepsy can't do these jobs — but it means the conversation about accommodations and safety is different.

The ADA's "direct threat" standard requires an individualized assessment based on current medical evidence. Your employer can't exclude you from a role based on assumptions about epilepsy in general — they have to evaluate whether your epilepsy, with your seizure pattern, in this specific role, creates a significant risk that can't be reduced through accommodation.

If you're in a safety-critical role: work with your neurologist to document your seizure control and any restrictions. Engage your employer's occupational health resources if available. And know that accommodations like modified duties, buddy systems, automatic shut-off equipment, and role adjustments exist for exactly these situations.