Generalized tonic-clonic seizure is a seizure that involves the entire body. It is also called grand mal seizure. The terms seizure, convulsion, or epilepsy are most often associated with generalized tonic-clonic seizures.

Seizure - tonic-clonic; Seizure - grand mal; Grand mal seizure; Seizure - generalized

Generalized tonic-clonic seizures may occur in people of any age. They may occur once (single episode), or as part of a repeated, chronic condition (epilepsy). Some seizures are due to psychological problems (psychogenic).

Many patients with generalized tonic-clonic seizures have vision, taste, smell, or sensory changes, hallucinations, or dizziness before the seizure. This is called an aura.

The seizures usually involve rigid muscles, followed by violent muscle contractions, and loss of alertness (consciousness).Other symptoms that occur during the seizure may include:

• Biting the cheek or tongue
• Clenched teeth or jaw
• Loss of urine or stool control (incontinence)
• Stopped breathing or difficulty breathing
• Blue skin color

After the seizure, the person may have:

• Normal breathing
• Sleepiness that lasts for 1 hour or longer
• Loss of memory (amnesia) regarding events surrounding the seizure episode
• Headache
• Drowsiness
• Confusion
• Weakness of one side of the body for a few minutes to a few hours following seizure (called Todd paralysis)

For more information about diagnosis and treatment, see:

• Epilepsy
• Seizures

Abou-Khalil BW, Gallagher MJ, Macdonald RL. Epilepsies. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 67.

Bodde NMG, Brooks JL, Baker GA, et al. Psychogenic non-epileptic seizures—diagnostic issues: a critical review. Clin Neuro Neurosurg. 2009;111:1–9.