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Grand mal seizure

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A grand mal seizure - also known as a tonic-clonic seizure - is a common type of seizure, characterized by loss of consciousness, falling down, loss of bowel or bladder control, and rhythmic convulsions. Seizures result from an abnormal electrical discharge in the brain. Other types of seizures include petit mal seizure and temporal lobe seizure.

The causes of seizures can vary. Many times the cause is unknown. Sometimes seizures run in families.

Repeated brain seizures characterize a seizure disorder known as epilepsy.

Signs and symptoms

A typical grand mal seizure starts with a loss of consciousness and falling down. This is followed by a 15- to 20-second period with muscle rigidity (tonic phase) and then a one- to two-minute period of violent, rhythmic convulsions (clonic phase). During a grand mal seizure, you may take on a dusky appearance, resulting from decreased blood oxygen levels due to impaired breathing during the seizure.

Most grand mal seizures last from one to two minutes. After the seizure, you may experience a headache and drowsiness or confusion. In most cases, seizures seem to occur randomly. But in rare cases, stimulation by light, sound, touch or reading can trigger a seizure in susceptible people. Sleep deprivation and excessive alcohol use also may trigger seizures.

Sometimes the seizures involve only a few muscles, such as one side of the face or one arm or leg. This is called a focal seizure.


During normal waking and sleeping, your brain cells produce various electrical discharge patterns. If the electrical discharges by your brain cells become abnormally synchronized, a convulsion or seizure occurs. The abnormal firing of your brain cells can remain localized to a small area or can spread rapidly to involve your entire brain.

Often, the cause of a seizure is unknown. Some of the known causes of seizures include:

  • Metabolic disturbances. Diseases of the kidney or liver can cause chemical disturbances in your body, as can very low levels of sodium, calcium or magnesium.

  • Previous brain trauma. A traumatic head injury, such as those sustained in automobile accidents or serious sports injuries, can cause seizures.

  • Vascular system problems. Blood vessel disorders and strokes are a common cause of seizures in older adults.

  • Toxic substances. Using drugs or other chemicals or withdrawing from addicting substances, especially alcohol, can affect your brain's electrical activity and your nervous system.

  • Infection. An inflammation of your brain, such as that caused by meningitis or encephalitis, may trigger a seizure.

  • Birth defects. Congenital malformations in the brain can be responsible for seizures in infants and young children.

  • Brain tumor. Although a brain tumor is an uncommon cause, a seizure may be the first indication of a brain tumor.

When to seek medical advice

Seek medical advice when any of the following occur:

  • The seizure lasts more than five minutes.

  • A second seizure immediately follows.

  • The person having the seizure is pregnant.

  • Signs of injury or illness are present.

If you see someone having a seizure, call for medical help immediately and then follow these tips:

  • Gently roll the person onto one side and put something soft under his or her head.

  • Loosen tight neckwear.

  • Don't put anything in the mouth — the tongue can't be swallowed.

  • Don't try to restrain the person.

  • Look for a medical alert bracelet, which may indicate an emergency contact person and other information.


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