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A generalized seizure, formally known as a gran mal seizure affects both sides of the brain, and starts in all parts of the brain at the same time. About 25 percent of people with epilepsy have generalized seizures. It affects all ages, socioeconomic and racial groups.

There are 4 phases of a generalized seizure:

1. Prodromal. This is the first phase where an early sign may include a group of symptoms hours or days before the seizure including depression, difficulty concentrating, headaches, insomnia and mood changes.
2. Aura. Typically, an aura occurs from a few seconds to a few minutes before the arrival of the seizure. Signs may include blurry vision, buzzing, ringing or an abdominal sensation.
3. Tonic-Clonic. This is the phase where the whole body is affected. The body begins to stiffen and the person loses consciousness and falls. This is followed by a violent uncontrollable shaking. During this phase, the person may have difficulty breathing, an inability to swallow, may drool and begin to sweat.
4. Postictal. Occurs at the end of the seizure, common signs include confusion, anxiety, depression, embarrassment, fear, memory loss, upset stomach and sleepiness.

There are 6 types of generalized seizures:

1. Absence (Petit Mal). It occurs throughout the entire brain beginning and ending very quickly. The person becomes unconscious with a blank stare. It may appear the person is day dreaming.
2. Tonic-Clonic. When the body stiffens and shakes. usually last 1 to 3 minutes.
3. Clonic. When a person has a muscle spasm in the face, neck and arms may last several minutes.
4. Tonic. The muscles in the arms, legs and trunk are affected. Usually last less than 20 seconds.
5. Atonic. the muscles go limp and can cause a person to fall or head his or her head if they are standing.
6. Myoclonic. Muscles suddenly jerk. The electrical impulses are strong enough to throw a person to the ground.

What Causes Epilepsy with Generalized Seizures?

Possible causes of epilepsy and seizures include:

• genetics
• a change in the structure of your brain
• autism
• an infections of the brain, such as meningitis or encephalitis
• head trauma
• a brain tumor
• Alzheimer’s disease
• a stroke, or a loss of blood flow to the brain resulting in brain cell death
• congenital conditions, including Down syndrome or tuberous sclerosis

First Aid For Tonic Clonic Seizures:

Call 911 if:

• The person has never had a seizure before.
• the person has difficulty breathing or waking after the seizure.
• The seizure lasts longer than 5 minutes.
• The person has a seizure back-to back.
• The person is injured during the seizure.
• The person has an additional condition like diabetes, or heart disease.

Steps

• Ease the person to the floor.
• Turn the person gently onto the side (this will help the person breathe).
• Clear the area around the person of anything hard or sharp
• Put something soft and flat, like a folded jacket, under his or her head.
• Loosen ties or anything around the neck including button on a shirt.
• Time the seizure.

Familiarize Yourself With The Warning Signs 

Each person is different. Typically warning signs of a seizure may include:

• Loss of consciousness
• Stiffening of the body
• Jerking of limbs
• Slight twitching
• A loss of awareness

Do Not:

• Do not hold the person down or try to stop his or her movements.
• Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue.
• Do not try to give mouth-to-mouth breaths (CPR). People usually start breathing again on their own after a seizure.
• Do not offer the person water or food until he or she is fully alert.

After the seizure:

After the seizure ends, the person will probably be groggy and tired. He or she also may have a headache and be confused or embarrassed. Try to help the person find a place to rest. If necessary, offer to call a taxi, a friend, or a relative to help the person get home safely.

Don’t try to stop the person from wandering unless he or she is in danger.

Don’t shake the person or shout.

Stay with the person until he or she is completely alert.

Resources

Epilepsy Ontario

Epilepsy Talk

Healthline

University of Chicago Medicine

WebMD