I t’s fine if you like watching TV medical dramas because you enjoy trying to stay a step ahead of House, M.D.’s weirdly brilliant diagnostic abilities or you have a crush on Dr. McDreamy from Grey’s Anatomy... but if you think you are learning about good medical care from such programs, think again -- what you see is likely not what you should do if you find yourself in a similar medical situation.

In real life, an enterprising medical student recently studied how doctors in the top four TV medical dramas responded to characters having seizures -- and found that they handled the situation wrong nearly half the time. Since any of us at any time could find ourselves in the presence of someone having a seizure with no doctor nearby, I think we all should know what these celebrity doctors have been doing wrong -- and what we should do instead.

Andrew Moeller, MASc, a medical student at Dalhousie University in Halifax, Nova Scotia, watched 364 episodes of House, Grey’s Anatomy, ER and Private Practice. Fifty-nine of the episodes depicted characters having grand mal seizures (the type where someone falls to the ground suddenly and begins to convulse uncontrollably). Nearly half the time (in 46% of the scenes), doctors made one or both of the following errors -- trying to stop the patient from moving around during the seizure... and/or putting something in the patient’s mouth, ostensibly to prevent the tongue from being swallowed. (Note: The latter was once a recommended approach but is no longer.)

I called Gholam Motamedi, MD, associate professor of neurology and director of the epilepsy fellowship program at Georgetown University Hospital, to ask about these depictions, and he called them "irresponsible." Dr. Motamedi explained that when a patient is having a grand mal seizure, the movements are powerful, uncontrolled and involuntary -- and that trying to restrain them could injure the patient. Similarly, putting an object in the mouth of a person having a seizure creates a choking risk... and using your fingers instead is not only not helpful but dangerous to you -- you might get bitten quite hard.

Actually, though all the instances of seizures shown on the TV programs were grand mal, which is the name given to generalized seizures, these aren’t the most common kind. Other types of seizures include absence seizure (characterized by a blank stare that lasts for several seconds)... and partial seizures, which include simple or petit mal seizures (less dramatic than grand mal). He told me that about 10% of people will have a seizure once in their lifetimes (often due to illness or injury), while 3% have two or more, which is the diagnosis criterion for epilepsy. While these are not large percentages, they are high enough that we should all know what to do.

Dr. Motamedi told me that the goal of anyone who finds himself in the presence of someone having a grand mal seizure is quite simple -- keep the person safe (see below) and get help. (For other types of seizures that do not involve convulsions, such as staring spells, stay with the person until he/she returns to normal and then see whether you can be of assistance.) Dr. Motamedi’s suggestions in case of a grand mal seizure...

Keep the person safe, but do not attempt to stop movements. You can put something soft beneath his/her head to cushion it... loosen jewelry, a necktie and/or shirt collar... and clear the area as much as possible of things that could cause injury, such as glassware and furniture with sharp edges.

The movements can continue for several minutes. When they subside, gently roll the person onto his/her side -- this helps keep the airway clear and reduces the danger of choking on saliva.

Be aware that during the seizure and for a while afterward, the person will not be responsive -- and may be confused or agitated (perhaps for several hours) even after consciousness returns. Stay so that you can help ease this transition or get help from someone else, perhaps offering assistance in contacting someone... or help the person get home or (if this was a first seizure or you don’t know the person) to the hospital.

Should you call 911? Yes, says Dr. Motamedi, if you are a bystander ... and yes, says the Epilepsy Foundation, unless you know the person and his/her history really well. For more information on epilepsy, including first-aid advice, visit the Epilepsy Foundation Web site at www.EpilepsyFoundation.org.