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 sends out electrical signals to your muscles, nerves, or glands.
These signals can make you lose consciousness and have severe muscle
Seizures can happen when you have a condition called epilepsy.
According to the Centers
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 5 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 or not depends on your history of
epilepsy or other conditions. Seek immediate medical help if this is your first
seizure or if you’ve been injured during the seizure.
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 your body
- drug or alcohol abuse or withdrawal
- having certain genetic conditions or
- injury or infection
Sometimes, doctors aren’t able to determine what triggered the
onset of your 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 include:
- sleep deprivation
- an electrolyte imbalance due to other medical
- the use of drugs or alcohol
of a Generalized Tonic-Clonic Seizure
If you have a tonic-clonic seizure, some or all of these symptoms
- a strange feeling or sensation, which is called
- 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
- 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
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 brain.
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 treatment.
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
There are two types of supplemental or alternative treatments for
grand mal seizures. Vagus nerve stimulation involves the 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 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
You can take steps in your daily life to help prevent seizures,
- Avoid traumatic brain injury by using motorcycle
helmets, safety belts, and cars with airbags.
- Use proper hygiene and practice appropriate food
handling to avoid parasitic infections that cause epilepsy.
- Reduce your risk factors for stroke, such as
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.