Grand mal

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).


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.)
     

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