Barring falling down and hitting one’s head, how do/can seizures kill?

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I understand that hitting one’s head on something can kill one seizure or no, but if that doesn’t happen, what kills them in the event of a fatal seizure?

In: Biology
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Cardiac arrest happens. Seizures are a malfunction and a reset of the body’s electrical system and so when it turns off, that’s bad, and if it takes too long to come back or malfunctioned really badly for too long then you are at increased risk of cardiac arrest and death from it.

Seizures begin as small groups of neurons firing abnormally, which coalesce into larger groups of electrically frenzied neurons that cause the seizure. When they’re in this state, those neurons can’t do their normal job.

Seizures that grow to involve critical areas of the brain that control life support activities like respiration and heart rate. If the seizure lasts long enough, the cessation of heartbeat and/or respiration can kill the victim.

The number one cause of death from a seizure is drowning- that’s why doctors advise against swimming alone and bathing for people who suffer epilepsy.

Similar to this, other major causes of injury and death from seizure are related to what you were doing right before the seizure happened, and this is why things like motor vehicle accidents, burns and workplace accidents are common too (also why doctors advise against both driving and using heavy machinery in people with epilepsy- in fact, laws often restrict driving for a period of time after your last seizure).

Some types of seizures make you lose consciousness, which means that if you vomited (for whatever reason), you lose the ability to cough that stuff out, should it slide down your windpipe. Some people go on to suffocate from the vomit, or get pneumonia.

Otherwise, when you’re in a seizure state, your brain cells are really active, really really active. If you seize long enough, there might not be enough oxygen arriving into your brain to feed the activity of these cells, which can lead to brain damage causing death.

Finally, there’s a group of people with epilepsy who were otherwise well, who suddenly die for reasons that we currently don’t know. This is known as Sudden unexpected death in epilepsy (SUDEP), and is very poorly understood.