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  • Tonic Clonic Seizures

ECG Cross Tonic clonic seizures (previously called grand mal seizures)

During a tonic clonic seizure a persons body stiffens and they fall to the ground [the tonic phase]. Their limbs then begin to jerk in strong, symmetrical, rhythmic movements [the clonic phase]. The person may dribble from the mouth, go blue or red in the face, and occasionally lose control of their bladder and/or bowel.

Although this type of seizure can be frightening to watch, the seizure itself is unlikely to seriously harm the person having the seizure. They may however vomit or bite their tongue and can sometimes injure themselves if they hit nearby objects as they fall or convulse. The seizure generally stops after a few minutes. At this time the person is usually confused and drowsy. They may have a headache and want to sleep. This drowsiness can last for a number of hours.

First Aid for Tonic Clonic Seizures

Safety position

DO
  • Remain with the person stay calm.
  • Note the time/length of the seizure.
  • Protect from injury remove any hard objects from the area.
  • Place something soft under their head. Loosen any tight clothing.
  • Gently roll the person on their side as soon as it is possible to do so and firmly push the angle of the jaw forward to assist with breathing. A person cannot swallow their tongue but the tongue can move back to cause a serious block to breathing.
  • Establish communication so that you know they have actually regained consciousness.
  • Reassure the person.
DO NOT
  • restrain the person's movements.
  • force anything into the mouth.
  • give the person water, pills or food until they are fully alert.

After the seizure, the person should be placed on their side. Keep in mind there is a small risk of post-seizure vomiting, before the person is fully alert. Therefore the person's head should be turned so that any vomit will drain out of the mouth without being inhaled. Stay with the person until he/she recovers (5 to 20 minutes).

Call an ambulance 000 if:
  • the seizure activity lasts 5 or more minutes or a second seizure quickly follows.
  • the person is not conscious within 5 minutes of the seizure stopping.
  • the seizure occurs in water.
  • the person is injured.
  • the person is pregnant or has diabetes.
  • you know, or believe it to be, the person's first seizure.
  • you are in doubt.

NB: Prolonged, continuous, or repetitive tonic clonic seizures require urgent medicalattention.

Epilepsy Australia National Help Line 1300 852 8653

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