Generalized tonic-clonic seizures
A generalized tonic-clonic seizure, sometimes called a grand
mal seizure, is a disturbance in the functioning of both sides of your brain.
This disturbance is caused by electrical signals spreading through the brain
inappropriately. Often this will result in signals being sent to your muscles,
nerves, or glands. The spread of these signals in your brain can make you lose
consciousness and have severe muscle contractions.
Seizures are commonly associated with a condition called epilepsy. According to the
for Disease Control and Prevention, about 5.1 million people in the United
States have a history of epilepsy. However, a seizure could also occur because
you have a high fever, a head injury, or low blood sugar. Sometimes, people
have a seizure as a part of the process of withdrawing from drug or alcohol
Tonic-clonic seizures get their name from their two distinct
stages. In the tonic stage of the seizure, your muscles stiffen, you lose
consciousness, and you may fall down. The clonic stage consists of rapid muscle
contractions, sometimes called convulsions. Tonic-clonic seizures usually last
1–3 minutes. If the seizure lasts longer than five minutes, it’s a medical
If you have epilepsy, you might begin to have generalized
tonic-clonic seizures in late childhood or adolescence. This type of seizure is
rarely seen in children under 2.
A one-time seizure that’s not related to epilepsy could
happen at any stage of your life. These seizures are normally brought about by
a triggering event that temporarily alters your brain functioning.
A generalized tonic-clonic seizure may be a medical
emergency. Whether the seizure is a medical emergency depends on your history
of epilepsy or other health conditions. Seek immediate medical help if this is
your first seizure, if you’ve been injured during the seizure, or if you have a
cluster of seizures.
of generalized tonic-clonic seizures
The onset of generalized tonic-clonic seizures could be
caused by a variety of health conditions. Some of the more severe conditions
include a brain tumor or a ruptured blood vessel in your brain, which can cause
a stroke. A head injury
could also trigger your brain to cause a seizure. Other potential triggers for
a grand mal seizure could include:
- low levels of sodium, calcium, glucose, or magnesium in
- drug or alcohol abuse or withdrawal
- certain genetic conditions or neurological disorders
- injury or infection
Sometimes, doctors aren’t able to determine what triggered
the onset of seizures.
is at risk for generalized tonic-clonic seizures?
You may be at a higher risk for having generalized
tonic-clonic seizures if you have a family history of epilepsy. A brain injury
related to a head trauma, infection, or stroke also puts you at higher risk.
Other factors that could increase your chances of having a grand mal seizure
of a generalized tonic-clonic seizure
If you have a tonic-clonic seizure, some or all of these
symptoms may occur:
- a strange feeling or sensation, which is called an aura
- screaming or crying out involuntarily
- losing control of your bladder and bowels either during
or after the seizure
- passing out and waking up feeling confused or sleepy
- a severe headache after the seizure
Typically, someone who has a generalized tonic-clonic
seizure will stiffen and fall during the tonic stage. Their limbs and face will
appear to jerk rapidly as their muscles convulse.
After you have a grand mal seizure, you might feel confused
or sleepy for several hours before recovering.
are generalized tonic-clonic seizures diagnosed?
There are several ways to diagnose epilepsy or what caused
Your doctor will ask you questions about other seizures or
medical conditions you’ve had. They might ask the people who were with you
during the seizure to describe what they saw.
Your doctor might also ask you to remember what you were
doing immediately before the seizure happened. This helps to determine what
activity or behavior may have triggered the seizure.
Your doctor will perform simple tests to check your balance,
coordination, and reflexes. They’ll assess your muscle tone and strength.
They’ll also judge how you hold and move your body and whether your memory and
judgment seem abnormal.
Your doctor may order blood tests to look for medical
problems that could influence the onset of a seizure.
Some types of brain scans can help your doctor monitor your
brain function. This could include an electroencephalogram (EEG),
which shows the patterns of electrical activity in your brain. It could also
incorporate MRI, which provides a detailed picture of certain parts of your
generalized tonic-clonic seizures
If you’ve had one grand mal seizure, it may have been an
isolated event that doesn’t require treatment. Your doctor could decide to
monitor you for further seizures before beginning a long-term course of
Most people manage their seizures through medication. You’ll
probably start off with a low dose of one drug. Your doctor will gradually
increase the dose as needed. Some people require more than one medication to
treat their seizures. It may take time to determine the most effective dose and
type of medication for you. There are many medications used to treat epilepsy,
Brain surgery may be an option if medications aren’t
successful in controlling your seizures. This option is believed to be more
effective for partial seizures that affect one small part of the brain than for
ones that are generalized.
There are two types of supplemental or alternative
treatments for grand mal seizures. Vagus nerve stimulation involves
implantation of an electrical device that automatically stimulates a nerve in
your neck. Eating a ketogenic diet, which is high in fat and low in
carbohydrates, is also said to help some people reduce certain types of seizures.
for people with generalized tonic-clonic seizures
Having a tonic-clonic seizure due to a one-time trigger may
not affect you in the long term.
People with seizure disorders can often live a full and
productive life. This is especially true if their seizures are managed through
medication or other treatments.
It’s important to continue using your seizure medication as
prescribed by your doctor. Suddenly stopping your medication could cause your
body to undergo prolonged or repeated seizures, which can be life-threatening.
People with generalized tonic-clonic seizures that aren’t
controlled by medication sometimes die suddenly. This is believed to be caused
by a disturbance in your heart’s rhythm as a result of muscle convulsions.
If you have a history of seizures, some activities may not
be safe for you. Having a seizure while swimming, bathing, or driving, for
example, could be life-threatening.
of generalized tonic-clonic seizures
Seizures are not well understood. In some cases, it may not
be possible for you to prevent a seizure if your seizures don’t appear to have
a specific trigger.
You can take steps in your daily life to help prevent
seizures. Tips include:
- Avoid traumatic brain injury by using motorcycle
helmets, safety belts, and cars with airbags.
- Use proper hygiene and practice appropriate food
handling to avoid infections, parasitic or otherwise, that cause epilepsy.
- Reduce your risk factors for stroke, which include high
blood pressure, high cholesterol, smoking, and inactivity.
Pregnant women should have adequate prenatal care. Getting
proper prenatal care helps to avoid complications that could contribute to the
development of a seizure disorder in your baby. After you give birth, it’s
important to have your child immunized against diseases that can negatively
affect their central nervous system and contribute to seizure disorders.