Granmol Seizures
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Granmol Seizures
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Epilepsy
Tonic-clonic seizures involve both tonic (stiffening) and clonic (twitching or jerking) phases of muscle activity.
Tonic-clonic seizures may start with a simple partial seizure or aura. The person may experience changes in sensation, mood or emotion leading up to the tonic-clonic seizure.
If you are with someone who has a tonic-clonic seizure:
Do not put anything in their mouth.
Turn them onto their side.
Make sure the area around their body is clear of objects that could hurt them.
Time the seizure.
Treatment for tonic-clonic seizures can involve medication, surgery, nerve stimulation, dietary therapy or a combination of these approaches.
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Tonic-clonic seizures, formerly known as grand mal seizures, comprise two stages: a tonic phase and a clonic phase. These intense seizures can be frightening to experience or observe, as extreme muscle spasms may temporarily arrest breathing.
The seizure may start with a simple or complex partial seizure known as an aura. The person may experience abnormal sensations such as a particular smell, vertigo, nausea, or anxiety. If the person is familiar with having seizures, they may recognize the warning signs of a seizure about to begin.
When the tonic-clonic seizure begins, the person loses consciousness and may fall. Strong tonic spasms of the muscles can force air out of the lungs, resulting in a cry or moan, even though the person is not aware of their surroundings. There may be saliva or foam coming from the mouth. If the person inadvertently bites their tongue or cheek, blood may be visible in the saliva.
Stiffness of the chest muscles may impair breathing, the person’s face may look bluish or gray, and he or she may make gasping or gurgling sounds.
Jerking movements affect the face, arms and legs, becoming intense and rapid. After one to three minutes, the jerking movements slow down and the body relaxes, sometimes including the bowel or bladder. The person may let out a deep sigh and return to more normal breathing.
After a seizure, the person may remain unconscious for several minutes as the brain recovers from the seizure activity. He or she may appear to be sleeping or snoring.
Gradually the person regains awareness and may feel confused, exhausted, physically sore, sad or embarrassed for a few hours. The person may not remember having a seizure, and may have other memory loss. Occasionally, people may have abnormal or combative behavior after a tonic-clonic seizure while the brain is recovering.
Witnessing a person having a tonic-clonic seizure can be upsetting, but it’s important to remember that most seizures resolve on their own after one to three minutes. To offer assistance:
Protect the person from injury by helping them to the floor and clearing away furniture or other items. Do not attempt to hold the person still.
Do not put anything in the person’s mouth. It is physically impossible to swallow one’s tongue, and putting things in the mouth may lead to injury.
A seizure lasting more than 5 minutes is an emergency. Call 911.
Calm reassurance can be helpful to a person who is recovering from a seizure.
After a person’s first seizure, it is important to consult with a physician. Parents or family members who observe the seizure can note the details and help create a written report that the person can take to the doctor. A video recording of the event (if available) can also aid in diagnosis.
To ascertain the cause of the seizure, the doctor may prescribe magnetic resonance imaging (MRI) or other tests to look for scarred areas in the brain. Electroencephalography (EEG) can help distinguish seizure disorders from other conditions.
If the doctor determines the person has a seizure disorder such as epilepsy, an individualized approach to treatment can help manage it. A range of therapies, including anti-seizure medication, nerve stimulation, dietary therapy and surgical procedures can address the seizures and, in many cases, bring them under control.
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Patti Greco is a writer and editor whose work has appeared in Glamour, Cosmo, Elle, and Bustle. For Health, she’s reported on such topics as COVID-19, dementia, and sickle cell anemia. Patti began her career in journalism 15 years ago, as an editorial assistant at Good Housekeeping, and was most recently on staff at Cosmopolitan, where she was the digital entertainment director and resident Jeremy Allen White fan (if you know, you know). She’s also held positions at MORE and New York Magazine’s Vulture. Offline, you can probably find her at a local dog run in Brooklyn, with her adorable Beagle/Jack Russell mix, Otis. But if you see her, don’t say hi: She’s pretty anti-social. (Just kidding! Say hi.)
When you think of a seizure , chances are a grand mal seizure is the first thing that comes to mind. It's the type of seizure that can cause a person to fall down, shake and jerk, and even lose consciousness.
But the term "grand mal seizure"—which technically means "big illness" in French—is actually an outdated one: In 2017, the International League Against Epilepsy (ILAE) came up with new ways to describe and classify seizures. As part of that, what was once known as a "grand mal seizure" is now called a "tonic-clonic seizure," according to the Epilepsy Foundation . ("Grand mal seizure" and "tonic-clonic seizure" will be used interchangeably throughout this article.)
Despite the new name, grand mal seizure is often the term people are most familiar with (some doctors even continue to use it in medical settings, especially if they don't specialize in seizures). Regardless of what you know them as—grand mal seizures or tonic-clonic seizures—here's what you need to know about them, including their main causes and how long they typically last.
A grand mal seizure is an example of a generalized onset motor seizure, or a generalized tonic-clonic seizure, the Epilepsy Foundation says. This means that the seizure starts in both sides of the brain. In some cases, however, tonic-clonic seizures can start on just one side of the brain (aka, a focal seizure), before spreading to both sides. The Epilepsy Foundation specifically calls this type of seizure a bilateral tonic-clonic seizure.
Grand mal seizures typically have two phases, per the Epilepsy Foundation: a tonic (stiffening) phase, followed by a clonic (jerking) phase—that's what has given them their current, more up-to-date name.
During a grand mal seizure, someone may also lose control of their bladder or bowels, per the Epilepsy Foundation—this happens when the body relaxes. If the person is having trouble breathing, they may also begin to take on a "dusky" or blue hue to their face.
Another common grand mal seizure symptom is an aura, according Johns Hopkins Medicine . This phenomenon, which generally happens just before the seizure, can include a range of abnormal sensations, like anxiety, nausea, and vertigo, and even smelling a particular odor.
Like all seizures , a grand mal or tonic-clonic seizure happens when there's a sudden surge of electrical activity in the brain. Usually, grand mal seizures are caused by epilepsy, per the Mayo Clinic . But grand mal seizures may also be caused by a medical problem, such as alcohol withdrawal, traumatic head injury, or an infection like meningitis . Other times still, the cause isn't known, and the seizure seems to happen at random.
"We always try to figure out the cause, because it's more satisfying to know why someone is having seizures, of course," Vikram Rao , MD, PhD, an associate professor of neurology at the University of California, San Francisco, tells Health . "But in many cases, we actually never do. It's not at all uncommon for there to be no obvious explanation."
A grand mal seizure usually lasts between one and three minutes, per the Epilepsy Foundation. After that, a person's consciousness can slowly return, but recovery after a grand mal seizure can take considerably longer. Many report feeling sleepy, confused, anxious, or agitated for hours after the fact.
If a seizure goes on for longer than five minutes—or if a person has three seizures in a row without regaining consciousness between them—they need emergency medical attention. In this case, the person is experienc
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