Health Encyclopedia

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:

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 lasts for one hour or longer
Loss of memory (amnesia) regarding events surrounding the seizure episode
Headache
Drowsiness
Confusion, temporary and mild
Weakness for up to 24-48 hours following seizure (This is called Todd's paralysis)

References

Foldvary-Schaefer N, Wyllie E. Epilepsy. In: Goetz CG. Textbook of Clinical Neurology. 3nd ed. St. Louis, Mo: WB Saunders; 2007.

Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.

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 Nov 20;69(21):1996-2007.

Spencer SS. Seizures and epilepsy. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.

Tomson T, Hiilesmaa V. Epilepsy in pregnancy. BMJ. 2007 Oct 13;335(7623):769-73.

Sheth RD, Hardin CL. Screening for bone health in epilepsy. Epilepsia. 2007;48 Suppl 9:39-41

Review Date:3/28/2009
Reviewed By:Reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.