040 68334455
WhatsApp
Patient Portal
Home Care
What is Tonic Clonic Seizures (Grand Mal Seizures)?
Written by Medicover Team and Medically Reviewed by Dr Vaishnavi A , Neurologist
Tonic-clonic seizures are a type of seizure that affects the whole brain and body. They used to be previously called as grand mal seizures. These seizures can be scary to see, but knowing what happens can help you stay calm and respond better.
During these seizures, a person usually loses consciousness and has strong muscle movements that can look scary but can be managed with proper care.
Here's what typically happens:
- Tonic phase: Muscles suddenly stiffen. The person may fall down.
- Clonic phase: Muscles jerk or twitch repeatedly.
These seizures happen because of unusual electrical activity in the brain. Sometimes the activity starts in one part of the brain (focal) and then spreads to involve the whole brain.
Tonic-clonic seizures are most often linked to epilepsy. But they can also be triggered by other health problems, such as a high fever or a head injury.
Some people may only have one seizure in their life and not need treatment. Others who have them more often may need daily medicines to help prevent them. In certain cases, surgery or special diets may also help control seizures.
What Are Types of Tonic-Clonic Seizures?
Tonic-clonic seizures can be grouped based on where they start in the brain. Understanding the types can help doctors figure out the best treatment and help you know what to expect.
Here are the main types of Tonic-Clonic Seizures:
Generalized Tonic-Clonic Seizures
Primary generalized tonic-clonic seizures start across the whole brain at once. They don't come from one single spot. This type is often seen in people with certain epilepsy conditions and usually begins without warning.
- Start all over the brain at once.
- There's no warning before it happens.
- The person suddenly loses consciousness and falls.
- Both sides of the body stiffen and jerk.
Focal to Bilateral Tonic-Clonic Seizures
Secondary tonic-clonic seizures start in one part of the brain, called a focal area, before spreading to both sides. That's why they're sometimes called focal to bilateral seizures.
- Start in one area of the brain (focal).
- The electrical activity then spreads to involve the whole brain.
- There might be a warning sign or aura before the seizure.
- The same stiffening and jerking movements happen once it spreads.
What Are Symptoms of Tonic-Clonic Seizures?
Tonic-clonic seizures are what many people think of when they hear the word seizure. They can be scary to witness, but knowing what to expect can help you stay calm and get help quickly.
These seizures have two main phases: tonic (stiffening) and clonic (jerking).
Here's what often happens:
- Sudden loss of consciousness
- Body stiffening
- Rhythmic jerking movements
- Eyes may roll back
- Breathing changes
- Possible drooling or foaming at the mouth
- Loss of bladder or bowel control
- Confusion after the seizure
It usually lasts 1 to 3 minutes. Then, the person often needs time to recover and rest.
If you see someone having a tonic-clonic seizure, stay calm. Gently turn them on their side, protect their head, and don't put anything in their mouth. Call for medical help if it lasts longer than 5 minutes or if it's their first seizure.
What Are the Causes of Tonic-Clonic Seizures?
Tonic-clonic seizures, sometimes called grand mal seizures, happen when there's a sudden burst of electrical activity in the brain that spreads quickly. This causes the body to stiffen (tonic phase) and then shake or jerk (clonic phase).
Some common reasons for Tonic-Clonic Seizures include:
- Epilepsy: The most common reason for repeated tonic-clonic seizures.
- Head Injuries: Past accidents or trauma can damage the brain and lead to seizures.
- Brain Infections: Conditions such as meningitis or encephalitis can affect the brain.
- Stroke: Interrupted blood flow may damage brain areas and cause seizures.
- Drug or Alcohol Withdrawal: Stopping them suddenly can lead to seizures in people dependent on these substances.
- Brain Tumors
- High Fever (Febrile Seizures in Children)
- Low Blood Sugar or Electrolyte Imbalance
Understanding what can trigger these seizures helps people avoid certain risks and manage their condition better.
Common Triggers
- Sleep deprivation
- Stress
- Alcohol and substance abuse
- Flashing lights
- Medication non-compliance
Get a second opinion from trusted experts and makeconfident, informed decisions.
Get Second OpinionHow Are Tonic-Clonic Seizures Diagnosed?
Diagnosing tonic-clonic seizures is an important step in making sure you get the right treatment and stay safe. Doctors begin by listening carefully to your symptoms and any details about the episodes you or family members can share. It helps to describe what happens before, during, and after a seizure.
Your doctor will also ask about your medical history, family history of seizures, and any triggers you've noticed. They may want to know if you've had infections, head injuries, or other conditions that could affect your brain.
Physical exams help check your overall health and nervous system function. This includes balance, reflexes, and muscle strength.
Since seizures can have many causes, doctors often look for underlying issues that might be treatable.
What Tests Diagnose a Tonic-Clonic Seizure?
Doctors use a few helpful tests to find out why someone is having tonic-clonic seizures. These tests help confirm the diagnosis and rule out other conditions.
Common tests include:
- EEG (Electroencephalogram): Checks electrical activity in the brain. It can show patterns linked to seizures, even between episodes.
- MRI and CT Scan: Takes detailed images of the brain. Helps find structural problems like tumors, scarring, or bleeding.
- Blood Tests: Look for infections, blood sugar issues, or chemical imbalances that can trigger seizures.
- Lumbar Puncture (Rarely): May be used if an infection in the brain is suspected.
These tests, along with your health history and a doctor's exam, help figure out the cause of your seizures. They're safe, common, and designed to give clear answers about what's happening in the brain.
How Are Tonic-Clonic Seizures Treated?
Tonic-clonic seizures can be scary, but with the right treatment, they can often be managed well. The main goal of Tonic-clonic seizure treatment is to reduce how often seizures happen and make them less severe. Treatment plans are personal, depending on age, overall health, and how often seizures occur.
Doctors usually start by learning about your seizure history and doing tests to understand what's causing them.
Tonic and clonic seizure treatment often involves:
- Medications: The most common way to control seizures. Taken daily to keep seizures away.
- Lifestyle adjustments: Getting enough sleep, reducing stress, and avoiding triggers.
- Safety planning: Making sure your home is safe in case of a seizure.
- Regular check-ups: To assess the effectiveness of treatment.
- Surgery (rare cases): When seizures don't respond to medicine.
It's important to follow the doctor's advice closely and not skip doses of medication. Even though there's no complete cure for epilepsy, many people live normal lives with good seizure control. Talk openly with your doctor about any side effects or worries so your plan can be adjusted as needed.
Common Anti-Seizure Medications for Tonic-Clonic Seizures
Anti-seizure medicines help prevent tonic-clonic seizures by calming the brain's electrical activity. They don't cure epilepsy, but they can reduce how often seizures happen and how strong they are.
The doctor will help choose the best one for you based on your age, health, and seizure type.
Some common options include:
- Valproic Acid: Often used for many types of seizures.
- Lamotrigine: Works well for both children and adults.
- Levetiracetam: Generally well tolerated with fewer interactions.
- Carbamazepine: Especially helpful for certain seizure types.
- Phenytoin: Used for many years, effective for tonic-clonic seizures.
Important tips for using anti-seizure medications:
- Take them exactly as prescribed.
- Don't skip doses, even if you feel well.
- Tell your doctor about side effects, like dizziness or tiredness.
- Avoid alcohol, which can interfere with seizure control.
- Get regular blood tests if recommended, to check levels.
With the right medication and care, many people with tonic-clonic seizures can live active, independent lives.
When to See a Doctor for Tonic-Clonic Seizure?
If you or someone you know has a tonic-clonic seizure, knowing when to see a doctor is very important. Even though seizures can be scary, some need urgent care while others need follow-up with a specialist.
See a doctor urgently if:
- The seizure lasts longer than 5 minutes
- The person has trouble breathing or doesn't wake up after
- There's a second seizure right away
- The person gets injured during the seizure
- It's their first-ever seizure
Your health is everything - prioritize your well-being today.
Consult Tonic Clonic Seizures Doctors Today
What to Do If Someone Has a Tonic-Clonic (Grand Mal) Seizure?
If you see someone having a tonic-clonic seizure, it can look scary, but staying calm and knowing what to do can help them stay safe.
Here's what you should do:
- Stay calm and reassure others nearby.
- Gently help them to the ground if they're standing.
- Turn them on their side if possible to help with breathing.
- Place something soft (like a folded jacket) under their head.
- Clear the area of anything hard or sharp.
- Do not hold them down or try to stop their movements.
- Do not put anything in their mouth. They can't swallow their tongue.
- Time the seizure. If it lasts longer than 5 minutes, call for emergency help.
- Stay with them until they're fully awake and aware.
By knowing these steps, you can really help keep someone safe during a seizure.
What is the Recovery Process After Tonic-Clonic Seizure Treatment?
Recovering after a tonic-clonic seizure can take time and care. Everyone's recovery is different, but the goal is to help you feel safe and reduce future seizures.
- Rest is important. Feeling tired or confused is normal.
- Medications help control seizures. Take them exactly as prescribed.
- Keep regular doctor appointments to adjust medicines if needed.
- Track seizures in a diary to spot patterns or triggers.
- Family or friends should know first-aid steps for seizures.
- Avoid known triggers like stress, lack of sleep, or alcohol.
- Discuss openly with your doctor any side effects or concerns you may have.
What are the Preventions for Tonic-Clonic Seizures?
While seizures can't always be fully prevented, there are ways to lower the risk of having them more often. Staying consistent with treatment and making healthy choices can really help.
Prevention tips:
- Take your seizure medication exactly as prescribed
- Get enough sleep every night
- Avoid skipping meals or becoming dehydrated
- Limit alcohol and avoid recreational drugs
- Manage stress with relaxation or breathing exercises
- Identify and avoid known seizure triggers (like flashing lights or certain patterns)
- Have regular check-ups with your doctor
- Wear a medical ID bracelet to let others know about your condition
Small daily steps can make a big difference. It's about taking care of your overall health and working closely with your healthcare team to keep seizures under better control.
Complications of Tonic-Clonic Seizures
Tonic-clonic seizures can have serious effects if not well-managed. It's essential to understand potential risks so you can plan and stay safer.
Possible complications include:
- Injuries from falling or hitting objects during a seizure
- Tongue or cheek biting
- Breathing difficulties during a seizure
- Confusion or tiredness afterwards
- Risk of status epilepticus (a long-lasting seizure that needs emergency care)
- There is a potential drowning risk if a seizure happens in water
- Emotional effects like fear or anxiety about having another seizure
Our Experience in Treating Tonic-Clonic Seizures
At Medicover Hospitals, we understand how scary and overwhelming tonic-clonic seizures can be for both patients and families. Our neurology department is here to treat you, ensuring you feel safe, informed, and supported every step of the way.
We've treated many people with these seizures and know that each person's needs are unique. Our experienced neurologists work closely with patients to find the right care plan.
