Understanding Tonic-Clonic Seizures: What To Expect And Essential First Aid Tips

International Epilepsy Day 2025: With appropriate care, most individuals with tonic-clonic seizures can live everyday lives.

Paramedics examining injured girl on street

International Epilepsy Day 2025: Seizures are a common and manageable medical condition that is often stigmatized due to a lack of awareness. There are various types of seizures, with tonic-clonic seizures garnering exaggerated attention due to their spontaneous and usually frightening presentation. Tonic-clonic seizures can occur as part of focal epilepsy, where the seizure starts in one area of the brain and spreads or is generalized simultaneously.

A tonic-clonic seizure involves two distinct phases:

1. Tonic Phase: This phase is characterized by stiffness and posturing of limbs and trunk, often associated with loss of consciousness. Due to laryngeal tightness and forceful breathing, a loud vocal sound may be heard.
2. Clonic Phase: This follows the tonic phase. It is when the person experiences rhythmic, jerking movements, which typically begin as fast amplitude jerks and gradually evolve into low-frequency, higher amplitude jerks towards the end and stop.

Seizures can cause falls and injuries like tongue bites or fractures, and they pose a risk of choking due to saliva or food entering the lungs. Most tonic-clonic seizures are brief, lasting only one to two minutes, and will end on their own. However, in some cases, they may last longer and require immediate medical attention.

First Aid: What To Do During A Tonic-Clonic Seizure

If the seizure lasts more than 2 minutes or if another one begins immediately after the seizure stops, call emergency medical services or transfer the patient to the nearest hospital. This may indicate a serious condition known as status epilepticus.

1. Move any objects or furniture away from the person to reduce the risk of injury.
2. Lay the person on their side and tilt their head downward to prevent choking by allowing saliva to drain and keep the airway open.
3. Avoid restraining or holding down the convulsing individual, as it may cause injury.
4. Do not put anything in the mouth object.
5. Giving a key or metal or making a convulsing patient smell shoes is useless, as these don't help.

Once the seizure ends, it is natural for the person to be exhausted, slightly disoriented, or confused. The confusion can last several minutes, and the patient may need time to regain full awareness. Keep them comfortable and encourage them to rest. Please don't give them anything to eat or drink until they are fully conscious and oriented.

Managing Tonic-Clonic Seizures

For people living with tonic-clonic seizures, long-term management focuses on medication and lifestyle changes.

1. Medical Testing: An accurate diagnosis begins with a thorough evaluation, including a detailed clinical history of the seizures, particularly a description of what happens during the seizure. Diagnostic tests like EEG (electroencephalogram) and MRI (magnetic resonance imaging) are often used to identify the underlying cause of epilepsy and guide treatment.
2. Medications: Anti-seizure medications are the mainstay of treatment. They significantly reduce or even eliminate seizure recurrence. These medications don't cure the condition but help to control it, allowing most individuals to live seizure-free or with minimal occurrences.

Lifestyle Adjustments seizure control. People living with epilepsy should:

1. Ensure they get enough sleep (8 hours each night).
2. Stick to a balanced diet with low glycemic index foods.
3. Yoga and meditation.
4. Follow a routine for medication.