What should you know about a grand mal convulsion?

The episode may begin with sudden loss of awareness and a fall, followed by stiff muscles and repeated jerking. The person may make an unusual sound as breathing changes, and they may bite their tongue or lose bladder control. A recovery period commonly includes sleepiness, confusion, headache, or aching muscles. The term describes what the seizure looks like; it does not identify the cause. Causes can include epilepsy, low blood glucose, alcohol withdrawal, infection, injury, or another change in brain function.

Move hard or sharp objects away, place something soft under the head, and remove glasses if possible. Do not hold the person down and do not place anything in the mouth. Time the convulsion, observe its pattern, and remain nearby. Once the jerking stops, roll the person onto their side and check that breathing is normal. Reassure them as they wake, and avoid offering food or drink until swallowing and alertness have returned.

Call emergency services when the convulsion lasts longer than five minutes, another seizure starts before recovery, breathing remains abnormal, or a serious injury occurs. Emergency help is also needed for a first seizure, a seizure in water, or one occurring during pregnancy. Severe headache, fever, stiff neck, or persistent confusion requires urgent assessment; meningitis is one condition that can cause dangerous brain inflammation.

Ask whether the event needs neurological assessment, which details witnesses should record, whether medicines or alcohol may have played a part, and how to respond if another convulsion happens. Ask when normal activities can restart.