Generalized tonic-clonic seizures



What are generalized tonic-clonic seizures?

A generalized tonic-clonic seizure, also known as a grand mal seizure, is a condition that features a loss of consciousness and violent muscle contractions. It’s the type of seizure most people picture when they think about seizures in general. Generalized tonic-clonic seizure is caused by abnormal electrical activity throughout the brain. Most of the time generalized tonic-clonic seizure is caused by epilepsy. In some cases, however, this type of seizure is triggered by other health problems, such as extremely low blood sugar, high fever or a stroke. Many people who have a grand mal seizure will never have another one. However, some people need daily anti-seizure medications to control and avoid future grand mal seizure.

How common are generalized tonic-clonic seizures?

According to some surveys, males slightly predominate, probably because of alcohol exposure and sleep habits. Please discuss with your doctor for further information.


What are the symptoms of generalized tonic-clonic seizures?

Generalized tonic-clonic seizures have two stages:

Tonic phase

Loss of consciousness occurs, and the muscles suddenly contract and cause the person to fall down. This phase may tend to last about 10 to 20 seconds.

Clonic phase

The muscles go into rhythmic contractions, alternately flexing and relaxing. Convulsions usually last for less than two minutes.

The common following signs and symptoms happen in some but not all people with generalized tonic-clonic seizures:


Some people experience a warning feeling (aura) before a grand mal seizure. This warning varies from person to person, but may include feeling a sense of unexplained dread, a strange smell or a feeling of numbness.

A scream

Some individuals with this condition may cry out at the beginning because the muscles around the vocal cords seize, forcing air out.

Loss of bowel and bladder control

This may happen during or following a seizure.

Unresponsiveness after convulsions

Unconsciousness may persist for several minutes after the convulsion has ended.


A period of disorientation often follows a grand mal seizure. This is referred to as postictal confusion.


Sleepiness is common after a grand mal seizure.

Severe headache

Headaches are common but not universal after grand mal seizures.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes generalized tonic-clonic seizures?

The onset of generalized tonic-clonic seizures could be caused by various health diseases. Some of the more severe conditions include a brain tumor or a ruptured blood vessel in your brain, which can cause a stroke. A head injury could also trigger your brain to cause a seizure. It is found that some other potential triggers for a grand mal seizure are able to include:

  • Low levels of sodium, calcium, glucose, or magnesium in your body
  • Drug or alcohol abuse or withdrawal
  • Having certain genetic conditions or neurological disorders
  • Injury or infection

Sometimes, doctors are not capable of determining what triggered the onset of your seizures.

Risk factors

What increases my risk for generalized tonic-clonic seizures?

You may be at a higher risk for having generalized tonic-clonic seizures if you own a family history of epilepsy. A brain injury related to a head trauma, infection, or stroke also puts you at higher risk. Some other common factors that could increase your chances of having a grand mal seizure include:

  • Sleep deprivation
  • An electrolyte imbalance due to other medical conditions
  • The overuse of drugs or alcohol

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How are generalized tonic-clonic seizures diagnosed?

If your doctor suspects that you may experience this condition, a physical examination will be performed and some tests will be also recommended by your doctor. Your doctor will ask you some questions about other seizures or medical conditions you have had. They also might ask the people who were with you during the seizure to describe what they saw. Your doctor might also ask you to remember what you were doing immediately before the seizure happened. This enables your doctor to determine what activity or behavior may have triggered the seizure. Additionally, your doctor will perform simple tests to check your balance, coordination, and reflexes. He or she will assess your muscle tone and strength and then also judge how you hold and move your body and whether your memory and judgment seem abnormal.

Some common tests are recommended to diagnose this condition by the doctor, include:

Blood Tests

Your doctor may order blood tests to look for medical problems that could influence the onset of a seizure.

Medical Imaging

Some types of brain scans can help your doctor monitor your brain function. This could include an electroencephalogram (EEG), which shows the patterns of electrical activity in your brain. It could also incorporate MRI, which provides a detailed picture of certain parts of your brain. 

How are generalized tonic-clonic seizures treated?

Some recommended treatment options of generalized tonic-clonic seizures may include:

Antiepileptic Medications

Most people manage their seizures through medication. You’ll possibly start off with a low dose of one drug. Your doctor will gradually increase the dose as needed. Some people require more than one medication to treat their seizures. Noticeably, it may take time to determine the most effective dose and type of medication for you. There are many medications used to treat epilepsy, including:

  • Carbamazepine (Carbatrol, Tegretol)
  • Phenytoin (Dilantin, Phenytek)
  • Oxcarbazepine (Trileptal)
  • Lamotrigine (Lamictal)
  • Phenobarbital
  • Lorazepam (Ativan)


Brain surgery may be an option if medications aren’t successful in controlling your seizures. This option is believed to be more effective for partial seizures that affect one small part of the brain than for ones that are generalized.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage generalized tonic-clonic seizures?

To reduce your risk of generalized tonic-clonic seizures and improve your general health:

  • Avoid traumatic brain injury by using motorcycle helmets, safety belts, and cars with airbags.
  • Use proper hygiene and practice appropriate food handling to avoid parasitic infections that cause epilepsy.
  • Reduce your risk factors for stroke, such as high blood pressure, high cholesterol, smoking, and inactivity.
  • If you have a seizure disorder, wear a medical bracelet to help emergency medical personnel. The bracelet should state whom to contact in an emergency, what medications you use and what drugs you’re allergic to.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 16, 2017 | Last Modified: August 16, 2017

You might also like