Seizures occur when abnormal electrical activity in the brain causes a temporary change in a person’s behavior. While seizures can occur at any point in life from causes like epilepsy, a brain injury, or an infection of the central nervous system, they become more difficult to manage at the end of life.

There can be a variety of factors for end-of-life seizures such as: metastatic brain cancers, hepatic encephalopathy and hypoglycemia, infection, drug withdrawal, stroke, or pre-existing epilepsy. Around About 25% – 50% of hospice patients who experience seizures have cancer metastases to the brain.

It can be a difficult and jarring event for a family member to witness. One of the most important things a caretaker can do when a loved one is experiencing a seizure is to make sure the patient is safe from further injury, whether it be from falling or hitting their arms or legs, or even worse, their head on nearby objects. Refrain from putting anything in their mouth as this can injure the jaw or teeth. Do not hold the patient down, however if possible, they can be turned gently onto one side to making breathing easier.

In these end-of-life circumstances anti-seizure medications may also not be the best course of action due to certain side effects such as sedation and cardiopulmonary depression. Medical treatments should only be left up to the patient’s hospice care team and be fully in adherence to the plan of care determined at the outset of admission.