Generalized tonic-clonic seizure
A generalized tonic-clonic seizure is a seizure involving the entire body. It is also called a grand mal seizure. The terms "seizure," convulsion," or "epilepsy" are most often associated with generalized tonic-clonic seizures.
For more information see:
Seizure - tonic-clonic; Seizure - grand mal; Grand mal seizure; Seizure - generalized
Causes, incidence, and risk factors
Generalized tonic-clonic seizures may occur in people of any age. They may occur once (single episode), or as part of a repeated, chronic condition (epilepsy).
Many patients with generalized tonic-clonic seizures have vision, taste, smell, or sensory changes, hallucinations, or dizziness before the seizure. This is called an aura.
- Biting the cheek or tongue
- Clenched teeth or jaw
- Loss of urine or stool control (incontinence)
- Stopped breathing or difficulty breathing
- Blue skin color
After the seizure, the person may have:
- Normal breathing
- Sleepiness that lasts for 1 hour or longer
- Loss of memory (amnesia) regarding events surrounding the seizure episode
- Weakness of one side of the body for a few minutes to a few hours following seizure (called Todd's paralysis)
For more information about diagnosis and treatment, see:
Signs and tests
Calling your health care provider
Duvivier EH, Pollack Jr CV. Seizures. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009: chap 100.
Kornblau DH, Conway Jr EE, Caplen SM. Neurologic Disorders. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Mosby Elsevier; 2009: chap 173.
Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69:1991-2007.
Schachter SC. Seizure disorders. Med Clin North Am. March 2009;93(2).
Trescher WH, Lesser RP. The Epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Jakovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa; Butterworth-Heinemann; 2008: chap 71.
Walker SP, Permezel M, Berkovic SF. The management of epilepsy in pregnancy. BJOG. 2009;116(6):758-67.
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