What should you know about generalized tonic seizure?

During the tonic phase, muscles tighten and the person may fall, become unresponsive or have a fixed gaze. Breathing can sound unusual, and the lips may look blue briefly. Jerking can follow as the seizure evolves, although the pattern varies. Afterwards, confusion, sleepiness, headache or muscle soreness may last for a while. A seizure is an event, not by itself a diagnosis of epilepsy; triggers and causes need medical assessment.

Move nearby hard or sharp objects away, cushion the head and loosen tight clothing around the neck. Do not restrain the person and do not put food, drink, medicine or fingers in the mouth. Turn the person onto their side when practical, especially after the stiffening or jerking eases, and stay until awareness returns. Note the start and end time and describe what happened to the clinician. If a prescribed seizure plan exists, follow it exactly.

Call emergency services if the seizure lasts five minutes or longer, another seizure begins before recovery, the person is injured, pregnant, diabetic, underwater or having trouble breathing after the event. Urgent assessment is also needed for a first seizure, a seizure with fever and severe headache or stiff neck, or a new change in the usual pattern. Do not drive the person yourself if they remain unresponsive.

Ask what may have triggered the event, whether an examination or brain and blood tests are appropriate, and how to reduce risks at home. Clarify when driving, swimming, bathing alone and working at heights are safe. Ask whether a rescue medicine or written seizure plan is needed and what family members should do if another event occurs.