Tonic Clonic Seizures

Tonic Clonic Seizures

A tonic clonic seizure is a seizure that has a tonic (muscle stiffening) and a clonic (muscle jerking) component, typically in this order. The older terms for tonic clonic seizures are “grand mal” or convulsions.

Tonic clonic seizures are the most recognised seizure type and can be frightening to witness. There are slight variations, but a typical tonic clonic seizure will last less than two minutes, and look like this:

• A sudden loss of consciousness, sometimes with vocalisation or crying out
• The eyes, head and body may turn in one direction
• The body becomes stiff (tonic), followed by jerking of the muscles (clonic)
• If standing, the muscle stiffening will cause the person to fall
• Breathing is compromised during the seizure which may cause the lips and face to look greyish/blue
• The person will not respond when spoken to
• Excess saliva may come of the person’s mouth, and there may also be blood if they have bitten their tongue or the inside of their cheek
• There may be loss of bladder control or less commonly bowel control
• Immediately after the seizure breathing can be quite laboured and sound like heaving snoring. This should rectify itself within a minute
• After the seizure there is usually a period of confusion, headache, soreness and sleepiness.

Because this seizure type causes considerable after effects, it is always important to have someone stay with the person until they are fully recovered.

Having a tonic clonic seizure in public places can create panic and people almost always call an ambulance. We recommend that people wear some form of medical ID if they do not wish to have an ambulance called.

Basic First Aid

1. Stay with the person
2. Time the seizure
3. Keep the person safe: protect from injury especially the head
4. Roll the person onto side after the seizure stops, or immediately if food, fluid, or vomit is in the mouth
5. Observe and monitor their breathing
6. Gently reassure them until they have recovered – it is a good idea to make sure they have someone that can go home with them

DO NOT

1. Put anything in the person’s mouth
2. Restrain the person – this may cause them to become agitated
3. Move the person,  unless they are in danger

When to Call an Ambulance

Seizures generally run their course and an ambulance isn’t always necessary. Call an ambulance if:

1. You are in any doubt
2. The person is injured
3. There is food, fluid or vomit in mouth (they may have inhaled it)
4. The seizure happens in water
5. The person has breathing difficulties after the seizure stops
6. Another seizure quickly follows
7. The seizure lasts longer than 5 mins
8. The person is non-responsive for more than 5 mins after the seizure ends

Seizure Posters and Videos