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Generalized Tonic Clonic Seizures In Children

AMBULATORY CARE:

A generalized tonic-clonic seizure

may also be called a grand mal seizure. A seizure means an abnormal area in your child's brain sometimes sends bursts of electrical activity. A generalized seizure affects both sides of the brain. Tonic and clonic are phases that happen during the seizure. The tonic phase causes your child's muscles to become stiff. He or she loses consciousness and may fall down. The clonic phase causes convulsions (repeated muscle contractions). A seizure may last from a few seconds up to 3 minutes. It is an emergency if it lasts longer than 5 minutes.

Common signs and symptoms of a tonic-clonic seizure:

  • Sudden loss of consciousness
  • Convulsions
  • Crying out
  • Not responding when spoken to
  • Biting his or her lips or cheeks
  • Loss of bladder control
  • Confusion and lack of energy after the seizure stops

Call 911 for any of the following:

  • This is the first seizure your child has ever had.
  • Your child has a second seizure within 24 hours of the first.
  • Your child has trouble breathing or feeling alert after a seizure.
  • The seizure lasts longer than 5 minutes.
  • Your child had a seizure in water, such as in a swimming pool or hot tub.

Seek care immediately if:

  • Your child is injured during a seizure.

Contact your child's healthcare provider if:

  • Your child feels he or she is not able to cope with having tonic-clonic seizures.
  • Your child's seizures start to happen more often.
  • Your child is confused longer than usual after a seizure.
  • You have questions or concerns about your child's condition or care.

Treatment:

Your child's healthcare provider may treat any health conditions causing the seizures. The goal of treatment is to try to stop the seizures completely. Your child may need any of the following:

  • Medicines may be given to treat certain health conditions. Your child may need antiepileptic medicine if the seizures are caused by epilepsy. He or she may need medicine daily to prevent seizures or during a seizure to stop it. Do not let your child stop taking the medicine unless directed by a healthcare provider.
  • A ketogenic diet may be needed to control your child's seizures if medicine does not work. The diet may be suggested by your child's healthcare provider and monitored by a dietitian.
  • Surgery may help reduce how often your child has seizures. This may be used if he or she has epilepsy and medicine does not help. Ask your child's healthcare provider for more information about surgery for epilepsy.

What you can do to help your child prevent a tonic-clonic seizure:

You may not be able to prevent every seizure. The following can help you and your child manage triggers that may make a seizure start:

  • Have your child take antiseizure medicine every day at the same time. This will also help prevent medicine side effects. Set an alarm to help remind you and your child.
  • Help your child manage stress. Stress can be a trigger for epilepsy. Exercise can help your child reduce stress. Talk to your child's healthcare provider about exercise that is safe for your child. Illness can be a form of stress. Offer your child a variety of healthy foods and give plenty of liquids during an illness. Talk to your healthcare provider about other ways to manage stress.
  • Set a regular sleep schedule. A lack of sleep can trigger a seizure. Try to have your child go to sleep and wake up at the same time every day. Keep your child's bedroom quiet and dark. Talk to your healthcare provider if your child is having trouble sleeping.

What you can do to help your child manage tonic-clonic seizures:

The following can help you manage the seizures if your child has more than one:

  • Keep a seizure diary. This can help you find your child's triggers and avoid them. Possible triggers include illness, lack of sleep, hormone changes, lights, and stress. Write down the dates of the seizures, where your child was, and what he or she was doing. Include how he or she felt before and after.
  • Record any auras your child has before a seizure. An aura is a sign that your child is about to have a seizure. Auras happen before certain types of seizures that are in only 1 part of the brain. The aura may happen seconds before a seizure, or up to an hour before. Your child may feel, see, hear, or smell something. Examples include part of your child's body becoming hot. He or she may see a flash of light or hear something. He or she may have anxiety or déjà vu. If your child has an aura, include it in the seizure diary.
  • Talk to your child about the seizure. Your child may be frightened or confused after a seizure. Depending on your child's age, it might be helpful to explain the seizure. If your child has epilepsy, help your child understand how epilepsy will affect him or her. Help your child learn safety precautions to take. Ask your child about any auras he or she had before the seizure. Help him or her learn to recognize an aura and get to a safe place before the seizure starts.
  • Ask what safety precautions your child should take. Talk with your adolescent's healthcare provider about driving. Your adolescent may not be able to drive until he or she is seizure-free for a period of time. You will need to check the law where he or she lives. Also talk to your child's healthcare provider about swimming and bathing. He or she may drown or develop life-threatening heart or lung damage if a seizure happens in water.
  • Have your child carry medical alert identification. Have your child wear medical alert jewelry or carry a card that says he or she has tonic-clonic seizures. Ask your healthcare provider where to get these items.
  • Create a care plan. Tell family, friends, school officials, and babysitters about your child's epilepsy. Your adolescent should also tell his or her coworkers if needed. Give others instructions that tell them how they can keep your child safe if he or she has a seizure.

How others can keep your child safe during a seizure:

Give the following to your child's family, friends, babysitters, school officials, and coworkers:

  • Do not panic.
  • Note the start time of the seizure. Record how long it lasts.
  • Gently guide your child to the floor or a soft surface. Cushion the child's head and remove sharp objects from the area around him or her.
    First Aid: Convulsions
  • Place your child on his or her side to help prevent him or her from swallowing saliva or vomit.
    First Aid: Convulsions
  • Loosen the clothing around your child's head and neck.
  • Remove any objects from your child's mouth. Do not put anything in your child's mouth. This may prevent him or her from breathing.
  • Perform CPR if your child stops breathing or you cannot feel his or her pulse.
  • Let your child sleep or rest after his or her seizure. He or she may be confused for a short time after the seizure. Do not give your child anything to eat or drink until he or she is fully awake.

Follow up with your child's healthcare provider or neurologist as directed:

If your child takes antiseizure medicine, he or she will need blood tests to check the level. The medicine may need to be changed or adjusted. Write down your questions so you remember to ask them during your visits.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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