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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.


  • Stay calm - remain with the person
  • Time the seizure
  • Protect from injury - remove any hard objects from the area
  • Protect the head - place something soft under their head and 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
  • Stay with the person until the seizure ends naturally and calmly talk to the person until the regain consciousness, usually within a few minutes
  • Reassure the person that they are safe and that you will stay with them while they recover.


  • 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).

In the event of a seizure follow instructions in the individual's seizure care plan.

However if you do not know the person, or there is no care plan:

Call an ambulance – 000/112- if:
  • the seizure activity lasts 5 or more minutes or a second seizure quickly follows.
  • the person remains non-responsive for more than 5 minutes after the seizure stops.
  • the person is having a greater number of seizures than is usual for them.
  • the person is injured, goes blue in the face or has swallowed water.
  • the person is pregnant.
  • you know, or believe it to be, the person's first seizure.
  • you feel uncomfortable dealing with the seizure at the time.

NB: Prolonged, continuous, or repetitive tonic clonic seizures require urgent medical attention