Tonic-clonic seizure (“grand mal”)
• These are the seizures with which the general public is most familiar.
• They have two phases:
- a tonic phase: the person gets suddenly stiff, makes a loud noise and could have difficulty breathing
- a clonic (jerking) phase: jerking is seen in the entire body
• They could be associated with tongue biting and urinary incontinence
• There is loss of consciousness
• Duration: several seconds to a few minutes.
• After the seizures, the patients are usually very tired and confused.
• EEG: spike waves (clonic) and electro-decremental response (tonic) followed by slowing by the end of the seizure