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Home Your Health Multimedia Encyclopedia Generalized tonic-clonic seizure

Generalized tonic-clonic seizure

Definition

A generalized tonic-clonic seizure is a seizure involving the entire body. It is also called a grand mal seizure. Such seizures usually involve muscle rigidity, violent muscle contractions, and loss of consciousness.

Generalized tonic-clonic seizures are the type of seizure that most people associate with the term "seizure," convulsion, or epilepsy. They may occur in people of any age, as a single episode, or as part of a repeated, chronic condition (epilepsy).

For more information see:

• Seizures
• Epilepsy
• Fever (febrile) convulsions
• Petit mal or absence seizures
• Partial (focal) seizures

Alternative Names

Seizure - tonic-clonic; Seizure - grand mal; Grand mal seizure; Seizure - generalized

Symptoms

Many patients have an aura (a sensory warning sign) before the seizure. This can include vision, taste, smell, or sensory changes, hallucinations, or dizziness.

The seizure itself involves:

• Loss of consciousness or fainting, usually lasting between 30 seconds and 5 minutes
• General muscle contraction and rigidity (tonic posture), usually lasting 15 - 20 seconds
• Violent rhythmic muscle contraction and relaxation (clonic movement), usually lasting for 1 -2 minutes
• Biting the cheek or tongue, clenched teeth or jaw
• Incontinence (loss of urine or stool control)
• Stopped breathing or difficulty breathing during seizure
• Blue skin color

Almost all people lose consciousness, and most people have both tonic and clonic muscle activity.

After the seizure, the person usually has:

• Normal breathing
• Sleepiness that lasts for 1 hour or longer
• Loss of memory (amnesia) regarding events surrounding the seizure episode
• Headache
• Drowsiness
• Confusion, temporary and mild
• Weakness of one side of the body for a few minutes to a few hours following seizure (This is called Todd's paralysis.)

For more information about diagnosis and treatment, see:

• Epilepsy
• Seizures

Support Groups

References

Duvivier EH, Pollack Jr CV. Seizures. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 100.

Kornblau DH, Conway Jr EE, Caplen SM. Neurologic Disorders. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Mosby Elsevier; 2009: chap 173.

Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69:1991-2007.

Schachter SC. Seizure disorders. Med Clin North Am. March 2009;93(2).

Trescher WH, Lesser RP. The Epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Jakovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa; Butterworth-Heinemann; 2008: chap 71.

Walker SP, Permezel M, Berkovic SF. The management of epilepsy in pregnancy. BJOG. 2009;116(6):758-67.