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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Generalized tonic-clonic seizure

Seizure - tonic-clonic; Seizure - grand mal; Grand mal seizure; Seizure - generalized

Last reviewed: February 10, 2014.

Generalized tonic-clonic seizure is one type of seizure that involves the entire body. It is also called grand mal seizure. The terms seizure, convulsion, or epilepsy are most often associated with generalized tonic-clonic seizures.

Causes

Generalized tonic-clonic seizures may occur in people of any age. They can occur once (single episode). Or they can occur as part of a repeated, chronic illness (epilepsy). Some seizures are due to psychological problems (psychogenic).

Symptoms

Many persons with generalized tonic-clonic seizures have vision, taste, smell, or sensory changes, hallucinations, or dizziness before the seizure. This is called an aura.

The seizures usually result in rigid muscles. This is followed by violent muscle contractions and loss of alertness (consciousness). Other symptoms that occur during the seizure may include:

After the seizure, the person may have:

  • Drowsiness or sleepiness that lasts for 1 hour or longer
  • Loss of memory (amnesia) about the seizure episode
  • Weakness of one side of the body for a few minutes to a few hours following seizure (called Todd paralysis)

Exams and Tests

The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system.

An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with seizures often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures.

Blood tests may also be ordered to check for other health problems that may be causing the seizures.

Head CT or MRI scan may be done to find the cause and location of the problem in the brain.

Treatment

Treatment for tonic-clonic seizures includes medications, changes in lifestyle for adults and children, such as activity and diet, and sometimes surgery. Your doctor can tell you more about these options.

References

  1. Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 67.
  2. Wiebe S. The epilepsies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 410.

Review Date: 2/10/2014.

Reviewed by: Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Phenobarbitone versus phenytoin monotherapy for partial onset seizures and generalised onset tonic‐clonic seizuresPhenobarbitone versus phenytoin monotherapy for partial onset seizures and generalised onset tonic‐clonic seizures
    Epilepsy is a disorder where recurrent seizures are caused by abnormal electrical discharges from the brain. Worldwide, phenobarbitone and phenytoin are commonly used antiepileptic drugs. This review found no evidence to suggest a difference between phenobarbitone and phenytoin for the control of the seizure types investigated. Phenobarbitone was more likely to be withdrawn than phenytoin, presumably due to adverse effects, however other factors may have influenced the rate of withdrawal of phenobarbitone in this review.
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