Tonic-Clonic Seizures: What Happens and How to Help
If you’ve ever wondered what a tonic-clonic seizure looks like, you’re not alone. These episodes are the classic “grand mal” seizures most people think of when they hear the word epilepsy. They start with a sudden loss of awareness, followed by stiffening (tonic phase) and then rhythmic jerking (clonic phase). The whole thing can last from a few seconds up to two minutes, and it often leaves the person feeling confused or exhausted afterward.
Common Signs & Symptoms
The first clue is usually a sudden fall or collapse. You’ll see the person’s muscles tighten – arms may fling out, legs lock, and breathing can pause for a moment. Then the clonic stage kicks in: rapid shaking of the limbs, sometimes with facial twitching. A tongue bite on the side, loss of bladder control, or frothy saliva at the mouth are also common. After the jerking stops, the person enters a post‑ictal phase – they might be sleepy, disoriented, or have a headache.
Not every seizure looks exactly the same. Some people keep their eyes open, while others stare blankly. The key is to notice the pattern: loss of consciousness, stiffening, and jerking. If you see these signs, it’s time to act.
Managing an Episode and Long‑Term Care
The first thing to do is stay calm. Move dangerous objects out of the way – think sharp corners or hot drinks – but don’t try to restrain the person. Gently roll them onto their side (the recovery position) once the shaking stops; this keeps the airway clear and prevents choking.
Time the seizure if you can. Most tonic‑clonic seizures end on their own within two minutes. If it goes longer, call emergency services right away. Also call for help if it’s the person’s first seizure, they’re injured, or breathing doesn’t resume quickly.
For ongoing management, talk to a neurologist about anti‑seizure meds. Common options include levetiracetam (Keppra), valproate, or carbamazepine. Your doctor will pick the right drug based on age, other health issues, and how often seizures happen. Lifestyle tweaks can help too – regular sleep, stress control, and avoiding alcohol or flashing lights that trigger episodes.
Keeping a seizure diary is a simple but powerful tool. Jot down when a seizure occurs, what you were doing beforehand, any warning signs, and how long it lasted. Over time you’ll spot patterns and can share the data with your doctor for better treatment decisions.
Family members and friends should know basic first‑aid steps. A quick refresher on recovery position, when to call 911, and what not to do (like putting anything in the mouth) makes a big difference. The more people understand tonic-clonic seizures, the safer everyone feels.
