Tonic‑Clonic Seizures: Quick Guide to Recognition and Response

If you ever see someone suddenly collapse, stiffen, then start shaking, you’re probably looking at a tonic‑clonic seizure. These episodes are the most familiar type of seizure, but they can still catch people off guard. Knowing the stages, what provokes them, and how to act can make a big difference.

What Happens During a Tonic‑Clonic Seizure?

The seizure has two clear phases. First, the tonic phase: muscles lock up, the person may fall, and breathing becomes shallow. This lasts 10‑20 seconds. Then comes the clonic phase, where the body jerks rhythmically for one to three minutes. After the shaking stops, the person often feels confused, tired, and may have a headache.

Common Triggers and How to Reduce Risk

Missing medication, lack of sleep, alcohol bingeing, and flashing lights can set off a tonic‑clonic seizure in someone with epilepsy. Stress and illness also play a part. Keeping a regular sleep schedule, taking meds exactly as prescribed, and avoiding known light patterns are practical ways to lower the chances.

For those without a diagnosed seizure disorder, head injury, fever in kids, or severe low blood sugar can provoke a similar episode. If you notice a seizure‑like event in a child with a high fever, get medical help right away—fever‑related seizures need prompt attention.

When you see a seizure, stay calm. Move any dangerous objects away, protect the head with a soft pillow or jacket, and time the event. If it lasts more than five minutes, call emergency services. Never put anything in the mouth; the person can’t swallow their tongue, but they can bite their cheek.

After the shaking stops, gently roll the person onto their side (the recovery position) to keep their airway clear. Offer reassurance once they’re alert, and stay until they’re fully aware of their surroundings. A brief period of confusion, called the post‑ictal state, is normal.

If the person has a seizure action plan, follow it. This may include giving emergency medication like rectal diazepam or a nasal spray. Having the plan written down and shared with family members helps everyone act quickly.

People who experience tonic‑clonic seizures often worry about driving, work, or school. Most regions require a seizure‑free period before a driver’s license is reinstated, but the exact rules vary. Talking to a neurologist about control strategies can clear up a lot of anxiety.

Finally, remember that seizures are medical events—not a sign of weakness or a moral failing. Supporting someone with epilepsy means encouraging medication adherence, helping them avoid known triggers, and being ready to act if a seizure happens.