Tonic-Clonic Seizures in Children

Tonic-Clonic Seizures

A tonic-clonic seizure is what most people associate with the idea of someone having a seizure as a result of epilepsy or another seizure disorder. These types of seizures used to be known as “grand mal” seizures, although this term is not as commonly used.

What Is a Tonic-Clonic Seizure?

The term tonic-clonic seizure refers to the two distinct tonic and clonic phases that make up the event. The tonic phase describes the initial stiffening of the muscles during the seizure, while the clonic phase indicates twitching and jerking.

While these seizures can be alarming to witness, by understanding the causes, signs of onset, and measures to take, children dealing with tonic-clonic seizures can receive the care and attention they need. We’re happy to share the following informational guide to help you be more engaged and work more closely with doctors and other treatment professionals to manage this condition.

How to Identify Tonic-Clonic Seizures and Underlying Causes

Like other seizures, a tonic-clonic seizure is caused by a disruption in the normal electrical impulses in the brain. Tonic-clonic seizures can start in both sides of the brain or a single side of the brain, where they are called generalized onset tonic-clonic seizures and focal to bilateral tonic-clonic seizures respectively.

There are four main phases of a tonic-clonic seizure, including:

  • Aura period: Before a full tonic-clonic seizure, there is often a partial seizure known as an aura. This is characterized by abnormal sensations and behaviors, including experiencing strange smells, vertigo, anxiety, or an upset stomach.
  • Tonic phase: The onset of the full seizure may involve loss of consciousness and falling. As the muscles stiffen it can cause a number of visible signs, including moaning or shouting as air is pushed out of the lungs, foaming or saliva in the mouth, and the potential for biting the lip, tongue, or cheek. This phase can also potentially impair breathing.
  • Clonic phase: For the next one to three minutes, the seizure will enter clonic activity of jerking and twitching. This will gradually lose intensity as the muscles begin to relax.
  • Postictal, or post-seizure, period: As the brain and body recover, the person undergoing the seizure may stay unconscious or appear to be sleeping. They will slowly regain consciousness, often reporting soreness, aches, and other pains. He or she may have some memory loss surrounding the event.

While a tonic-clonic seizure may be disturbing to witness, the event will usually resolve itself in a manner of minutes. It’s important to make sure the surrounding area is free of objects, and that the person is turned onto their side during a seizure. Never put anything in the mouth of a person experiencing any type of seizure.

Tonic-clonic seizures may be caused by a seizure disorder such as epilepsy, or they could be related to another cause. It is critical to see a qualified doctor for diagnosis and treatment if your child has experienced a seizure.

Diagnosing Tonic-Clonic Seizures

To diagnose the underlying cause of a tonic-clonic seizure, doctors will perform a thorough evaluation that includes reviewing medical history, asking questions about seizure events, and performing a number of diagnostic tests. Tests may include magnetic resonance imagery (MRI) of the brain, and electroencephalography (EEG) to confirm the presence of epilepsy or rule out other causes.

Tonic-Clonic Seizures Treatment Options

Managing tonic-clonic seizures may involve personalized treatment measures, including anti-seizure medication, electric nerve stimulation, and nutritional therapy. Specific medications include anticonvulsants such as ethosuximide (Zarontin), lamotrigine (Lamictal), and valproic acid (Depakene). Due to side effects and individual responses, the right type of medication will vary from patient to patient.

Behavioral therapy and counseling can also help manage any related emotional issues that can come with seizure disorders such as epilepsy and help children and families cope with the condition.

Caring for a Child with Tonic-Clonic Seizures

For many families, pediatric home health services can be an essential part of the treatment picture for tonic-clonic seizures and related conditions such as epilepsy. An experienced nurse can help your family get to the best possible outcome with any seizure disorder by assisting with needs such as medication management, nutrition, and 1:1 supervision.

Contact Sonas for Home Health Care in Florida

It can be hard to balance your time between work, home, and caring for a child. That’s why our team of skilled professionals at Sonas Home Health Care is here to help. We have been enforcing precautionary measures and following the Centers For Disease Control (CDC) guidelines for COVID-19 to ensure the safety and health of our clients and employees.

Our home health care services offer support in the comfort of your home. We refer loving and competent nurses to provide customized care for families — from a few hours a day to around-the-clock supervision. Contact us directly to speak with a home health care professional or request a free in-home assessment. Together we can determine the best plan of action to keep your loved ones happy and healthy.

If you or a loved one are considering Pediatric Home Health Care Services in Florida, contact the caring staff at Sonas Home Health Care. Call today at (888) 592-5855.

Jillian Miller
Jillian Miller BSN, RN
Director of Nursing at

This blog was reviewed by Jillian Miller BSN, RN — Director of Nursing for Sonas Home Health Care’s Tampa Bay market — for clinical accuracy. Jillian Miller has been a nurse for 16 years — working primarily in pediatrics. She believes the best part of working with the pediatric population is when you see smiles from clients when you first enter the room. She loves seeing the difference you can make in families’ lives while providing the best care possible for them.

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