Sawan is the Malay word for a seizure (fit or convulsion), and epilepsy (epilepsi) is a brain condition that causes repeated seizures; one seizure does not always mean epilepsy. During a seizure the body may go stiff or floppy and jerk, or the person may stare and stop responding, and it usually stops by itself within a few minutes. If you see one, cushion the person's head, do not hold them down, never put anything in their mouth, time it, and turn them on their side afterwards. Call 999 if it is a first seizure, lasts more than 5 minutes, or they do not recover. About 7.8 in 1,000 Malaysians have had epilepsy, and up to 70% of people with epilepsy could become seizure-free with the right treatment.
What is sawan, and is it the same as epilepsy?
Sawan is the Malay word for a seizure, also called a fit or convulsion in English.
According to the NHS, epilepsy is a condition that affects your brain and causes seizures. It cannot currently be cured, but treatment can often help manage it. The World Health Organization (WHO) describes seizures as brief episodes caused by excessive electrical discharges in a group of brain cells.
Having a seizure does not always mean you have epilepsy, as seizures can have other causes. For example, young children can have a seizure when they have a high temperature (sawan demam). According to the NHS, you will usually be diagnosed with epilepsy if you have had more than one seizure, or if tests show you are at risk of having more.
How common is epilepsy in Malaysia?
A nationwide door-to-door survey of 16,686 people in Malaysia, led by neurologists at Universiti Malaya with the Ministry of Health's Institute for Public Health, found:
- a lifetime epilepsy prevalence of 7.8 per 1,000 people;
- a prevalence of active epilepsy of 4.2 per 1,000 people;
- among respondents who completed a diagnostic interview after screening positive, more had had febrile seizures only (57.6%) than epilepsy (14.4%).
Worldwide, about 50 million people have epilepsy, making it one of the most common neurological diseases, according to the WHO.
Tanda sawan: what does a seizure look like?
Usually the only symptom of epilepsy is having seizures. According to the NHS, symptoms of a seizure can include:
- your body becoming stiff or floppy;
- suddenly falling to the floor;
- jerking or twitching movements;
- peeing unintentionally;
- losing awareness: staring into space and not responding normally;
- unusual feelings, such as strange smells, numbness or tingling, changes in vision, or suddenly feeling scared;
- unusual behaviour, such as fidgeting or walking around without being aware of it.
Numbness or tingling on its own has many other causes; see our guide to tangan kebas. A seizure usually lasts a few seconds or minutes and stops by itself. Epilepsy often starts in young children and people over 50, but it can happen at any age.
| Type of seizure | What happens |
|---|---|
| Tonic-clonic | You become unconscious and may fall; your muscles get stiff and your body jerks and shakes |
| Tonic | Your muscles suddenly get stiff and you may fall, then recover quickly |
| Atonic | Your muscles suddenly go floppy and you may fall, then recover quickly |
| Absence | You briefly lose awareness of what is going on around you |
| Focal | You have unusual feelings, sensations or movements |
| Myoclonic | Your muscles briefly jerk |
Source: NHS, epilepsy.
What should you do when someone has a seizure?
It can be frightening to watch, but do not panic. According to the NHS, if you are with someone having a seizure:
- only move them if they are in danger, such as near a busy road or a hot stove;
- cushion their head if they are on the ground;
- loosen any tight clothing around their neck, such as a collar or tie, to help breathing;
- note the time the seizure starts and finishes;
- turn them onto their side (the recovery position) after the jerking stops;
- stay with them and talk calmly until they recover.
Do not put anything in their mouth, including your fingers or a spoon, and do not give them any food or drink until they have fully recovered. If they are in a wheelchair, put the brakes on, leave any seatbelt on and support their head, but do not try to move them.
It also helps the doctor if you note what the person was doing before the seizure, which parts of the body jerked or stiffened, whether their colour or breathing changed, and how they were afterwards.
When should you call 999?
Call 999 and ask for an ambulance if:
- it is the first time the person has had a seizure;
- the seizure lasts longer than is usual for them, or more than 5 minutes if you do not know;
- they do not regain full consciousness, or have several seizures without recovering in between;
- they have had 3 or more seizures in 24 hours;
- they are seriously injured during the seizure;
- they have difficulty breathing afterwards.
People with epilepsy do not always need to go to hospital. They usually have a care plan that says what to do, such as giving emergency medicine. According to the NHS, a seizure that lasts a long time, or several seizures without recovering in between, is called status epilepticus and needs urgent treatment to prevent brain damage.
See a doctor urgently if you think you or your child may have had a first seizure and did not go to hospital, or if you have a seizure after a long time without any.
Sawan demam: febrile seizures in children
According to the NHS, a febrile seizure can happen when a child has a high temperature. They usually affect children between 6 months and 6 years old and usually last 2 to 3 minutes. A febrile seizure can seem frightening, but it is not usually serious and is unlikely to cause long-term harm. Your child may become stiff, twitch or shake, become unconscious, be sick or wet themselves, and be sleepy, irritable or confused for up to an hour afterwards.
Call 999 if your child has a seizure for the first time, it lasts more than 5 minutes, they have difficulty breathing, the stiffness or twitching is on only one side of the body, they are more sleepy than usual for more than an hour afterwards, or they have more than one seizure in 24 hours.
While you wait, protect their head, remove dangerous objects nearby, and do not hold them down or put anything in their mouth. Do not try to cool your child by undressing them or sponging them with cold water. After the seizure, put them in the recovery position. For fever care, see our guide to demam; for one common childhood infection that causes a fever, see HFMD.
Febrile seizures are not the same as epilepsy. Children who have had one have a slightly increased chance of epilepsy later in life, but this is rare.
Punca sawan: what causes seizures and epilepsy?
According to the WHO, epilepsy is not contagious, and in about 50% of cases worldwide the cause is unknown. Known causes include:
- brain damage before or around birth, such as a lack of oxygen, trauma during birth or low birth weight;
- genetic conditions and abnormalities of the brain present from birth;
- a severe head injury;
- a stroke (see our guide to angin ahmar);
- a brain infection, such as meningitis or encephalitis;
- a brain tumour.
The WHO estimates that about 25% of epilepsy cases are potentially preventable, and preventing head injuries, for example from falls and traffic accidents, is the most effective way.
In people with epilepsy, the NHS lists things that can trigger a seizure, such as tiredness, stress, periods, flashing lights, certain food or drink, too much alcohol and missed doses of epilepsy medicine.
How is epilepsy diagnosed?
If you or your child have had a seizure, you will need to see a specialist doctor. They will ask what happened before, during and after the seizure, so it helps to bring someone who saw it. According to the NHS, tests may include:
- an EEG (electroencephalogram) to check electrical activity in the brain;
- an ECG (electrocardiogram) to check the heart;
- brain scans such as an MRI or CT scan;
- blood tests and genetic testing.
Ubat sawan: how is epilepsy treated?
The main treatment for epilepsy is anti-seizure (anti-epileptic) medicine to prevent seizures. According to the WHO, up to 70% of people with epilepsy could become seizure-free with the right medicine. The medicine chosen depends on the type of seizures, your age, sex and other conditions, and you may need to try more than one.
- You may also be given an emergency medicine for a family member or carer to use if a seizure lasts longer than usual.
- Do not change your dose or stop your medicine without talking to your specialist. If you have had no seizures for 2 years, your specialist may suggest gradually reducing it.
- If medicines do not work, other options include brain surgery, a small device under the skin of the chest (vagus nerve stimulation) and a specialist ketogenic diet.
Pregnancy: some epilepsy medicines can harm an unborn baby. If you or your partner take epilepsy medicine and there is a chance of pregnancy, talk to your specialist before you get pregnant. Do not stop your medicine on your own.
Living with epilepsy
For most people, medicine works well and epilepsy has a small impact on daily life. The NHS suggests:
- make sure your family and friends know what to do if you have a seizure;
- carry medical ID, such as a bracelet or card;
- keep a seizure diary to help spot triggers;
- take showers instead of baths if you can, and think about safety when cooking, swimming, using tools or doing sports;
- do not miss doses, and do not drink too much alcohol.
If you have had a seizure, do not drive until you have talked to your doctor about whether it is safe and what the law requires. If tiredness is a trigger, see our guide to susah tidur.
In many places, people with epilepsy still face stigma, according to the WHO. Epilepsy is a long-term condition of the brain, and for most people treatment keeps seizures well controlled.
Frequently asked questions (FAQ)
What is sawan in English?
Sawan is the Malay word for a seizure, also called a fit or convulsion. Epilepsy (epilepsi) is a condition of the brain that causes repeated seizures. Having one seizure does not always mean you have epilepsy, because seizures can have other causes, such as a high temperature in young children.
What should I do if someone is having a seizure?
Stay calm. Only move them if they are in danger, cushion their head, loosen anything tight around their neck, and note the time the seizure starts and stops. When the jerking stops, turn them onto their side in the recovery position and stay with them until they recover. Do not hold them down and do not put anything in their mouth.
Should I put a spoon or my fingers in their mouth?
No. The NHS says not to put anything in the mouth of someone having a seizure, including your fingers. They should not have any food or drink until they have fully recovered.
When should I call 999 for a seizure?
Call 999 if it is the person's first seizure, if it lasts more than 5 minutes (or longer than is usual for them), if they do not regain full consciousness or have several seizures in a row, if they are seriously injured, or if they have difficulty breathing afterwards.
Is sawan demam (a febrile seizure) dangerous?
Febrile seizures can happen when a child aged 6 months to 6 years has a high temperature. They can seem frightening but are not usually serious and are unlikely to cause long-term harm. Your child still needs to be checked in hospital after a first febrile seizure, and you should call 999 if it lasts more than 5 minutes or your child has difficulty breathing.
Can epilepsy be cured?
Epilepsy cannot currently be cured, but treatment can often control it. According to the World Health Organization, up to 70% of people with epilepsy could become seizure-free with the right anti-seizure medicine. Some people may be able to stop treatment after 2 years without seizures, but only with their specialist's advice.
Is epilepsy contagious?
No. Epilepsy is not contagious, so you cannot catch it from someone. In about half of cases worldwide the cause is unknown; known causes include brain damage around birth, genetic conditions, severe head injury, stroke, brain infections and brain tumours.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. If someone is having a seizure that lasts more than 5 minutes, or it is their first seizure, call 999. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
