Tonic-Clonic type of seizure (also called a convulsion) is what most people think of when they hear the word “seizure.” An older term for this type of seizure is “grand mal.” As implied by the name, they combine the characteristics of tonic and clonic seizures. Tonic means stiffening, and Clonic means rhythmical jerking.
The tonic phase comes first-
· All the muscles stiffen.
· Air being forced past the vocal cords causes a cry or groan.
· The person loses consciousness and falls to the floor.
· A person may bite their tongue or inside of their cheek. If this happens, saliva may look a bit bloody.
After the tonic phase comes the clonic phase-
· The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees.
· After a few minutes, the jerking slows and stops.
The person’s face may look dusky or a bit blue if they are having trouble breathing or the seizure lasts too long. The person may lose control of their bladder or bowel as the body relaxes. Consciousness, or a person’s awareness, returns slowly.
Tonic-clonic seizures can start in one or both sides of the brain. When they start in both sides of the brain, they are called generalized onset motor seizures or a generalized tonic-clonic seizure. When they start in one side of the brain and spread to affect both sides, the term focal to bilateral tonic-clonic seizure is used.
The typical appearance of a tonic-clonic seizure is usually easy to recognize. A cell phone video or written description of what happens is very helpful for the doctor to know if this could be a seizure. An electroencephalography (EEG) and other tests may help confirm the diagnosis or suggest a cause. EEG is an important test for diagnosing epilepsy because it records the electrical activity of the brain.
The main way of treating seizures is by taking medicines daily. There are also special medicines used only when a person has more seizures than usual or to help stop further tonic-clonic seizures from occurring after it is taken. These are called rescue medicines. A special diet for epilepsy may also help control seizures in children and adults with epilepsy. Devices (such as vagus nerve stimulator or responsive neurostimulator) are also available to help treat seizures that don’t respond to seizure medicine.
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