Hyperekplexia Home Support in Patna: Exaggerated Startle Episodes, Mobility Safety and Daily Activity Support
A documented four-week home care case study of a 36-year-old woman living with hyperekplexia — covering startle-trigger management, fall prevention, physiotherapy-supported mobility, family education and daily activity adaptation, coordinated alongside her treating neurologist.
At a Glance
| Patient | Mrs. Shweta Mishra (name used for educational purposes) |
|---|---|
| Age / Gender | 36 years / Female |
| Location | Patna, Bihar |
| Primary condition | Hyperekplexia — exaggerated startle response with brief stiffening episodes |
| Present since | Childhood; episodes became more disruptive in adulthood |
| Medical oversight | Continuing neurological follow-up with her treating team; home team provided supportive coordination only |
| Medications | Not documented in this case file — managed solely by the treating neurologist |
| Family support | Husband and mother (both trained in episode response) |
| Duration of care | Four-week structured home safety and mobility program |
| Services involved | Home nursing oversight, physiotherapy-guided mobility support, doctor coordination, family training, home safety audit |
| Final outcome | Greater confidence moving around the home; avoidable environmental triggers reduced; independence in personal care maintained; underlying condition unchanged (as expected) |
Understanding Hyperekplexia
Hyperekplexia is a rare neurological disorder characterised by an unusually strong and often involuntary response to unexpected stimuli such as sudden sounds, touch or movement. A person may suddenly become stiff or experience a brief episode of increased muscle tone after being startled. In some individuals, these episodes can affect walking or cause falls.
The condition can be inherited or, less commonly, occur without a clear family history. In many hereditary families, hyperekplexia has been linked to changes in genes affecting glycinergic inhibition in the brainstem and spinal cord — most commonly the GLRA1 gene, with other genes also implicated. However, whether this applied to Mrs. Mishra was not documented, and no genetic testing results were available to the home team. Severity also varies considerably between individuals — some people live with a lifelong but manageable startle response, while others face more frequent or disabling episodes.
Three clinical points shaped this case:
- The startle reflex itself is involuntary. Family education therefore focused on the environment and communication, not on asking the patient to “react less.”
- The main injury risk is falls during the brief stiffening that follows a startle — particularly on stairs, in bathrooms and while carrying objects.
- Home support does not eliminate the underlying disorder. Its purpose is to reduce avoidable hazards, support safe movement and help the person manage everyday activities — working alongside, never instead of, neurological care.
For context on other neurological conditions we support at home, see our guides on understanding Parkinson’s disease and post-stroke care at home.
Patient Background
Medical history
Shweta had experienced an exaggerated startle response since childhood, but the episodes had become more disruptive during adulthood. Sudden sounds, unexpected touch and rapidly approaching people could sometimes trigger a brief stiffening episode. She had previously received a neurological evaluation establishing the diagnosis and was continuing follow-up with her treating team. No other chronic illnesses were documented in the case file provided for this educational study.
Lifestyle & family situation
She lived in a family home in Patna with her husband and mother, both actively involved in her daily life. She remained socially engaged but had begun avoiding crowded places such as busy markets, and preferred quieter routes when going outdoors.
Risk factors identified at intake
- Environmental: sudden household noise (kitchen appliances, dropped items), cluttered walking routes, stair use, unpredictable outdoor noise.
- Situational: being approached or touched unexpectedly, especially from behind; carrying objects while moving.
- Psychological: growing anticipatory anxiety — she was increasingly worried that a sudden startle might make her lose balance.
- Consequential: slower completion of household activities and creeping avoidance of crowded environments, which can gradually reduce independence.
Reason for the home assessment
Over the preceding months, Shweta had become increasingly cautious while walking because she feared a sudden startle could make her fall. Her family requested a home assessment to improve safety while preserving her independence — not to take over her care. This is an important distinction and shaped the entire plan. Families often face this exact decision point; our guide on why families in Patna trust structured home care explains how a professional assessment separates real risks from unnecessary restrictions.
Clinical Diagnosis & Functional Assessment
Diagnosis
Hyperekplexia — previously established through neurological evaluation by her treating team. The home healthcare team did not re-diagnose the condition; its role was to document current function, environmental risk and response patterns, and to relay any changes back to the treating neurologist.
Presenting concerns (documented at assessment)
- Sudden stiffening after unexpected sounds
- Increased startle response to unexpected touch
- Fear of falling during an episode
- Reduced confidence while walking outdoors
- Difficulty using stairs quickly
- Avoidance of crowded environments
- Increased anxiety about unexpected movements around her
- Slower completion of household activities
Her family also noticed she was especially cautious when moving through areas with sudden or unpredictable noise — an observation that directly informed the trigger-management plan.
Initial functional assessment (documented at Day 0)
| Domain | Documented finding | Clinical interpretation |
|---|---|---|
| Mobility | Walked independently under normal circumstances; a sudden startle could temporarily interfere with movement and make her feel unstable | Independent walker between episodes; startle-related instability is the key safety issue, not baseline walking ability |
| Transfers | Could get up from a chair independently but preferred stable furniture nearby | Safe transfers; habit of using stable furniture is protective and was reinforced, not corrected |
| Stair use | Used the handrail and avoided rushing on stairs | Already applying good stair technique — to be maintained |
| Daily activities | Independent with eating, dressing and personal hygiene, but needed extra time for tasks involving stairs, carrying objects or crowded spaces | Independence intact; support should target high-risk situations, not routine self-care |
Medical Evaluation & Treatment Context
Shweta’s diagnosis had been established previously by her treating neurologist through clinical neurological evaluation, and she continued regular follow-up. No hospital admission occurred during the four-week home program, and none was required — her condition was stable and community-managed.
- Investigations (blood reports, imaging, genetic tests): not documented in this case file; not performed by the home team.
- Medications: details not documented. Medication management remained entirely with the treating neurologist. The home team’s role was limited to supporting adherence logistics and escalating observed changes in her pattern.
- Home team’s clinical scope: functional assessment, environmental safety audit, physiotherapy-guided mobility support, family education, episode documentation and coordination with the treating team.
This scope separation is deliberate. Medical treatment for hyperekplexia — where required — is individualised by the treating specialist. Home healthcare works best as a structured extension of clinical care into the home, not as an alternative to it.
Why Home Healthcare Was Needed
Shweta’s condition was medically stable — the risks she faced were environmental, situational and behavioural. That is precisely the profile where home-based support is clinically appropriate, because the hazards themselves live inside the home and the daily routine. Clinic visits can describe a startle trigger; only a home assessment can stand in the kitchen doorway where appliances startle her, or walk the staircase she is afraid to rush on.
Structured support through professional home healthcare in Patna allowed the plan to operate where the episodes actually occurred — while she stayed in her own environment, surrounded by her own people, rather than being removed to institutional care she did not medically need. Families weighing this decision can read our detailed review of whether home care is safe in Patna when properly supervised.
- The risk map is home-specific. Startle triggers, stair layout, bathroom conditions and lighting differ in every house. A generic hospital advice sheet cannot capture them; a home safety audit can.
- Independence was the goal, not dependence. She was independently mobile and self-caring. Institutional care would have been unnecessary and potentially harmful to her confidence.
- Family response is the first intervention. Episodes occur without warning. The people standing next to her — her husband and mother — needed structured training in what to do and, just as importantly, what not to do.
- Documentation changes outcomes over time. A written record of triggers, circumstances and response outcomes allows the treating neurologist to see patterns that a 10-minute OPD visit cannot reveal.
The full care model behind this approach — nursing oversight, physiotherapy and coordination in a single team — is described in our guide to patient care services at home, and the importance of specialist nursing input is discussed further in the importance of specialised nursing services in Patna.
Home Care Plan by AtHomeCare
The plan mapped every documented problem to a specific intervention with a named responsible role. Nothing was introduced “just in case” — every element responded to a documented need.
| Documented goal | Intervention | Responsible role |
|---|---|---|
| Reduce fall risks | Home safety audit; pathway clearing; lighting; stair & bathroom review | Nursing team + family |
| Identify & manage startle triggers | Trigger log; communication-before-touch protocol; noise awareness plan | Family (coached by nursing team) |
| Improve confidence during mobility | Physiotherapy-guided walking, sit-to-stand and balance practice | Physiotherapist (see physiotherapy at home in Patna) |
| Adapt daily activities for safer movement | Task modification: dressing, kitchen, cleaning, outdoor routines | Nursing team + family |
| Encourage independence without unnecessary restriction | Assistance reserved only for genuinely higher-risk tasks | Whole team |
| Help the family respond correctly during an episode | Episode response training + documentation routine | Nursing team |
| Maintain specialist oversight | Escalation criteria agreed; changes relayed to treating neurologist; home doctor visit coordination | Coordinating doctor + treating team |
Managing Startle Triggers
The family learned that predictable communication could reduce unnecessary surprises. Since the startle reflex is involuntary, the practical lever the family controlled was how and when unexpected things happened around her.
1. Before touching
Family members were encouraged to speak to Shweta before touching her unexpectedly. For example, they could say her name before approaching her from behind. This small habit converts an “unexpected touch” — a documented trigger — into an expected, announced contact, and costs nothing.
2. Reducing sudden noise
The family tried to avoid unnecessary loud noises around frequently used areas of the home. Kitchen appliances and other noisy equipment were used with reasonable awareness of her location. This is environment-aware household behaviour, not noise elimination — the home still functioned as a normal home. The broader principle that a person’s surroundings (light, noise, routine) materially affect safety and recovery is discussed in our guide on the impact of the home environment on recovery.
3. Predictable environment
Frequently used furniture and household objects were kept in consistent locations. This reduced the need for sudden movements or hurried navigation — both of which increase the chance of a startle-adjacent loss of balance. Families creating this kind of stable, low-hazard setup will find practical room-by-room guidance in our article on creating a safe and comfortable home (the principles apply to any person with mobility-related safety concerns, not only seniors).
Mobility and Physiotherapy Support
The rehabilitation plan focused on safe movement — not on attempting to eliminate the startle response, which no exercise can do. Physiotherapy was delivered and progressed under professional supervision, consistent with the individualised approach described in why physiotherapy matters for healing through movement and the practical delivery model explained in at-home physiotherapy services.
🚶 Walking practice
Shweta practiced walking at a comfortable pace on clear indoor pathways. She was encouraged to turn and change direction gradually rather than rushing — because rapid directional change is precisely when a startle-induced stiffening episode is most likely to cause a loss of balance.
🪑 Sit-to-stand practice
Controlled sit-to-stand movements were practiced using a stable chair. The goal was to maintain lower-limb strength and confidence during transfers — the same movement she already used safely, reinforced with better technique. Strength maintenance directly supports transfer safety; our guide on customised rehabilitation and strength-building programs explains how exercise plans are matched to individual ability.
⚖️ Balance training
Appropriate balance exercises were included only under physiotherapy supervision, individualised according to her mobility and fall risk. Exercises were selected to be safe even if a startle occurred mid-exercise — for example, practicing near stable support rather than in open space.
🚫 What physiotherapy deliberately did not attempt
It did not try to suppress the startle reflex, push her toward crowded environments, or progress faster than her confidence allowed. Fear of falling is a recognised barrier that slows recovery in many movement conditions — an issue explored in how fear delays mobility recovery. Progress was therefore confidence-paced, not calendar-paced.
Fall Prevention at Home
The family reviewed the home environment carefully, room by room, with the nursing team. The complete methodology is described in our comprehensive guide to fall prevention; the specific measures applied in this home were:
🧹 Clear pathways
Furniture, loose bags and electrical wires were removed from major walking routes. A clear pathway means that when a startle occurs, her feet are more likely to find stable ground.
🚿 Bathroom safety
The bathroom floor was kept dry and uncluttered. Appropriate support equipment could be considered following a professional assessment — not guessed at. Families arranging such assessments can review available supports on our medical equipment rental page for Patna.
🪜 Stair safety
A secure handrail was available on the staircase, and Shweta avoided carrying large or heavy objects while using stairs — because carrying a load both occupies the hands and raises the consequences of a startle.
💡 Lighting
Good lighting was maintained in hallways, on stairs and in other frequently used areas. A night light was placed along her bedroom-to-bathroom route, because even a familiar route becomes a hazard in darkness if a startle occurs at night.
Families applying these measures elsewhere will find the same checklist logic in safety-first home modifications and fall prevention and in our fall-prevention guidance for seniors — the environmental principles are universal even though this patient was 36.
What the Family Did During a Startle Episode
This was the most important training of the entire program, because episodes continued to occur and the first sixty seconds determine whether they are harmless or injurious.
✅ The correct response (as trained)
- Remain calm. A panicked response adds a second startle stimulus.
- Do not pull or suddenly move her. Grabbing someone mid-stiffening can convert a stable episode into a fall.
- Give her space to regain control of her movement.
- Stay nearby. If she became temporarily unable to move safely, family members stayed close and helped prevent injury without forcing her into a different position.
- Document any unusual or prolonged episode and discuss it with her healthcare team.
❌ The mistakes the training was designed to prevent
- Grabbing her arm to “steady” her the instant she stiffens.
- Shouting instructions or crowding around her.
- Trying to walk her somewhere mid-episode.
- Treating a prolonged or injury-associated episode as “normal for her” instead of reporting it.
The general skill of spotting early danger signs and responding correctly is covered in recognising warning signs and emergency response at home; if a fall with injury ever occurs, the structured approach in post-fall nursing observation applies.
Daily Activity Adaptation
Each routinely risky task was redesigned so that safety did not depend on luck. The underlying principle: remove the situation where a startle and a hazard can collide.
| Activity | Documented risk | Adaptation applied |
|---|---|---|
| Dressing | Prolonged standing and hurrying | Clothing organised so she did not need to hurry; she sat down for tasks requiring balance or prolonged standing |
| Kitchen | Carrying hot liquids while moving quickly | Avoided carrying hot liquids while moving quickly; frequently used items kept within easy reach |
| Household cleaning | Ladders, rapid movement, heavy loads | Tasks requiring ladders, rapid movement or heavy carrying assigned to family members; smaller tasks divided across the day |
| Outdoors | Crowded, unpredictable environments | Family member nearby in crowded or unfamiliar places; quieter routes chosen when possible |
Families supporting someone through tasks like these — with the right balance of help and independence — will find the practical division of roles described in daily care assistance at home and personal care and hygiene support. For situations where a companion’s presence itself is the safety intervention (as outdoors in crowds), see how companion caregivers reduce fall risk.
Exercise and Activity Pacing
Shweta was encouraged to remain physically active within her safe limits — total rest was never on the table. She used short periods of activity followed by rest, rather than completing demanding tasks continuously. The rhythm was simple and repeatable:
The goal was to maintain function without creating unnecessary fatigue or rushing — because fatigue and hurry are both hidden amplifiers of startle-related risk. Staying gently, consistently active is a principle that holds at every age, as our article on the importance of staying active at any age explains.
Emotional and family support
The unpredictable nature of startle episodes had made Shweta worried about falling — a psychological burden with a real functional cost. Her family responded by:
- Encouraging her to remain involved in activities she could safely perform;
- Avoiding treating her as completely dependent, and instead providing assistance only during situations with a genuine safety concern;
- Maintaining a predictable home routine, which reduced unnecessary stress.
Understanding the emotional side of long-term conditions matters as much as the physical side — our guides on understanding mental health and emotional companionship care cover this dimension for families.
Equipment Considerations
Depending on her individual assessment, the rehabilitation team considered:
- Stair handrails (already secured and verified)
- Bathroom support equipment (to be decided following professional assessment)
- Stable seating with appropriate height
- Non-slip footwear
- Mobility aids — only if clinically indicated
A walking aid was not introduced automatically, because Shweta remained independently mobile. Where assessment does justify equipment, it can be sourced without purchase burden through medical equipment rental in Patna, with the correct item selected against a clinical need rather than a catalogue.
Four-Week Home Safety & Functional Plan — Timeline
Each stage below records the clinical focus, the interventions applied, and the patient and family response as documented.
Clinical focus
Establish the baseline, make the environment safer, and start the data collection that would guide everything else.
Interventions
- Identified common startle triggers through structured interview and home walk-through.
- Cleared walking pathways; improved lighting; reviewed stair and bathroom safety.
- Established the family communication routine before unexpected touch (“say her name first”).
- Began recording the frequency and circumstances of episodes in the family log.
Patient & family response
Shweta engaged readily with the audit; her husband and mother adopted the communication-before-touch routine within the first days. The episode log immediately made trigger patterns visible — sudden kitchen sounds and approach-from-behind touch appeared most often.
Clinical focus
Rebuild movement confidence under safe, supervised conditions.
Interventions
- Continued prescribed mobility exercises.
- Practiced controlled sit-to-stand movements using a stable chair.
- Continued safe indoor walking on cleared pathways, with gradual turns.
- Reviewed balance and transfer techniques with the physiotherapist.
- Maintained predictable movement patterns around the home.
Patient & family response
She reported that turning slowly felt “less risky” than her old hurried turns. Family members stopped moving furniture and kept belongings in fixed places, making her routes genuinely predictable.
Clinical focus
Translate improved movement confidence back into ordinary life.
Interventions
- Encouraged independent personal-care activities (no over-assistance).
- Resumed selected light household tasks, using the Activity → Rest → Activity rhythm.
- Practiced safe movement between rooms.
- Gradually increased tolerated activity within safe limits.
- Continued tracking startle-related incidents in the log.
Patient & family response
Shweta resumed light kitchen tasks within her adapted routine — items within reach, no hurried carrying of hot liquids. The family correctly continued handling only the genuinely higher-risk tasks (ladders, heavy loads), showing the training had distinguished help from over-help.
Clinical focus
Convert a four-week program into a sustainable routine, and close the loop with her treating team.
Interventions
- Maintained all fall-prevention measures (pathways, lighting, stair and bathroom rules).
- Continued individualised physiotherapy exercises independently.
- Reviewed outdoor mobility needs — quieter routes, family company in crowds.
- Updated the family response plan with lessons from the log.
- Discussed any significant symptom changes with the treating team.
Patient & family response
The family described the routine as “normal life with better habits” — the intended end state. Escalation criteria remained written and visible.
Beyond week 4: the program transitioned to a maintenance routine — continued exercises, ongoing trigger log reviews, periodic home safety re-checks and continuing neurological follow-up. Where specialist review required in-person assessment that was difficult to arrange, doctor home visit services provided the bridge between home monitoring and clinic-based care.
Clinical Evidence — Documented Observations
Supporting documentation reviewed for this case
- Initial home functional assessment notes (Day 0)
- Home safety audit checklist (pathways, lighting, stairs, bathroom)
- Physiotherapy session notes and exercise log (Weeks 2–4)
- Family episode record (trigger, setting, response, outcome entries)
- Week-4 review notes and family feedback summary
- Treating-team correspondence record (escalation criteria and updates)
Documented startle triggers & applied management
| Documented trigger | Typical response described | Management applied |
|---|---|---|
| Sudden sounds (kitchen appliances, dropped items, household noise) | Brief stiffening; momentary feeling of instability | Noise-aware appliance use near her location; predictable layout so hurried navigation was unnecessary |
| Unexpected touch (especially from behind) | Startle with increased muscle tone | Communication-before-touch protocol: say her name before approaching or touching |
| Rapidly approaching people | Startle response; withdrawal from the situation | Family trained to approach from the front at a calm pace; visitors briefed |
| Crowded / unpredictable-noise environments | Marked caution; avoidance | Quieter routes chosen; family member nearby in crowded places; no forced exposure |
Documented functional progression (Day 0 → Week 4)
| Domain | Day 0 (documented) | Week 4 (documented) |
|---|---|---|
| Indoor walking | Independent; a sudden startle could temporarily make her feel unstable | Independent with greater confidence; gradual-turn technique in routine use; episodes still occurring (condition unchanged) |
| Transfers | Independent; preferred stable furniture nearby | Maintained; controlled sit-to-stand technique reinforced through practice |
| Stairs | Handrail use; avoided rushing | Safe technique maintained; continued avoiding carrying loads on stairs |
| Personal care | Independent (eating, dressing, hygiene) | Independence maintained — no over-assistance introduced |
| Higher-risk tasks | Extra time needed; inconsistent informal help | Structured: family assistance reserved for genuinely higher-risk tasks only |
| Crowded places | Avoided | Continues to prefer quieter routes with family nearby (unchanged, appropriately cautious) |
| Psychological | Fear of falling; anxiety about unexpected movements | Reported greater confidence moving around the home; predictable communication reduced unnecessary startles and stress |
Warning Signs & Emergency Symptoms
- A significant increase in startle frequency
- New or prolonged stiffening episodes
- Increasing falls
- New difficulty walking
- New weakness or coordination problems
- Episodes occurring without an identifiable trigger
- Injury associated with an episode
- A major change in her usual pattern of symptoms
- Serious injury after a fall
- Loss of consciousness
- Seizure-like activity
- Severe breathing difficulty
- Sudden severe weakness
- Prolonged unresponsiveness
- Any acute condition causing rapid deterioration
Escalation advice: in any of the above, call your local emergency number (112 in India) or go to the nearest emergency department immediately — do not wait for a routine review. Inform the treating neurologist afterwards so the episode pattern can be updated.
Outcome After Four Weeks
What improved
After four weeks, Shweta reported greater confidence while moving around her home. She remained affected by exaggerated startle episodes, but the family had reduced several avoidable environmental triggers. Improved lighting, clear pathways and better communication before unexpected touch helped her feel safer during routine activities.
What was maintained
She continued to perform most personal-care tasks independently and used family assistance for activities with a higher risk of falling. Lower-limb strength and transfer confidence were maintained through the physiotherapy program, and the family’s response skills were now habitual rather than rehearsed.
What did not change
The hyperekplexia itself. The home program supported safety and function — it did not cure the condition. This honest framing was shared with the family from Day 1, and it shaped realistic expectations throughout.
Remaining challenges & long-term plan
- Startle episodes continue; trigger management remains an ongoing family habit, not a completed task.
- Outdoor and crowded settings remain approached cautiously — appropriately so.
- Physiotherapy exercises continue independently, with review if her pattern changes.
- The family episode log remains active and is discussed with her treating team at follow-up.
- Home safety measures are reviewed periodically, as hazards creep back into every home over time.
Family feedback (documented)
The family reported that the single most valuable change was the simplest one: speaking before touching. They described the home as feeling “calmer and more predictable,” and — importantly — reported that they no longer felt helpless during episodes, because they knew exactly what to do and what not to do.
The continuity model behind outcomes like this — one accountable team spanning nursing, physiotherapy, equipment and doctor coordination — is described in AtHomeCare Patna’s service framework, and in the guide to complete patient care at home through nursing and physiotherapy.
Key Clinical Learnings
- Hyperekplexia causes an exaggerated response to unexpected sounds, touch or movement — and the reflex is involuntary, so education must target the environment and communication, not willpower.
- Sudden stiffening can temporarily interfere with safe mobility. The danger moment is the seconds after the startle — on stairs, in bathrooms, while carrying objects.
- Fall prevention is a core component of home support, layered across environment, task modification and maintained strength.
- Family members can reduce avoidable surprises by communicating before approaching or touching the person — a zero-cost, high-impact intervention.
- Clear pathways, good lighting and secure stairs reduce injury risk — environmental review belongs in every neurological home assessment.
- Physiotherapy helps maintain strength, mobility and confidence when appropriately individualised and supervised; it does not remove the startle response and must not be progressed faster than confidence allows.
- Significant changes in episode frequency, duration or mobility must reach the treating team. Documentation is what makes pattern change visible.
- Home support complements neurological care and never replaces it. Scope discipline — the home team does not diagnose, prescribe or reinterpret — is what makes it safe.
- Equipment follows assessment. An unnecessary walking aid is not a safety measure; it is a confidence tax.
Frequently Asked Questions
1. What can trigger a hyperekplexia episode?
2. Can someone with hyperekplexia walk independently?
3. How can a home be made safer for a person with hyperekplexia?
4. Can physiotherapy help with hyperekplexia?
5. When should a doctor be contacted?
6. Can hyperekplexia be cured?
7. What should family members do during a startle episode?
8. Does anxiety make startle episodes worse?
9. Are mobility aids always needed in hyperekplexia?
10. How does home support fit with neurological treatment?
Contact AtHomeCare Patna
Speak to our care coordination team
If someone in your family lives with hyperekplexia, Parkinson’s disease, stroke recovery or another neurological condition affecting mobility and daily safety, a structured home assessment is the first step. Our team will coordinate with your treating doctors — never around them.
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🌐 Website: patna.athomecare.in
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This is a fictional patient case study intended for educational and informational purposes only. It does not represent a real patient, and “Mrs. Shweta Mishra” is an illustrative identity. It should not replace diagnosis, treatment or medical advice. Hyperekplexia can affect individuals differently, and neurological treatment, rehabilitation and safety planning should be guided by qualified healthcare professionals.
No laboratory values, medications, imaging findings or genetic results have been fabricated; where such information was not part of the documented case material, this has been stated explicitly. If you or a family member experience a medical emergency — serious injury after a fall, loss of consciousness, seizure-like activity, severe breathing difficulty, sudden severe weakness or prolonged unresponsiveness — seek emergency medical care immediately.