Dealing with a Tonic-clonic Seizure

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Tonic-clonic seizures are a common form of epileptic seizure. This leaflet gives some tips on how a bystander can help. There are different types of epilepsy.

Seizures can vary enormously in their type and duration. The following is a guide to assist a person who is having a seizure.

  • Note the time.
  • Do - prevent crowds gathering round.
  • Do - place a cushion or some clothing under the head to prevent injury.
  • Do not - try to restrain the person. If there is a warning (aura) before a seizure, it may be possible to guide the person to a safe place or cushion the expected fall to the ground. When the seizure starts, do not try to hold the person upright, but let them lie down.
  • Do not - move the person unless they are in a dangerous place (for example, in a road or next to a fire). If possible, move dangerous objects away from the person.
  • Do not - place anything in the person's mouth, or try to move the tongue.
  • Do - roll the person on to their side into the recovery position.
  • Do - check that breathing has resumed normally. It is normal for breathing to stop for a short while during the stiff (tonic) part of the seizure. The face will go pale or bluish. During the convulsive (clonic) part, breathing is irregular. After the seizure is over, breathing returns to normal. If not, check there is nothing stopping breathing such as food or false teeth. The recovery position helps saliva and anything in the mouth, such as food or sick (vomit), to drain out of the mouth and not back into the throat.
  • Do - stay and talk to the person. Give reassurance until they are fully recovered. It may take a while for the person to wake up fully. Do not leave a person alone whilst they remain dazed or confused.
  • Do not - offer something to eat or drink until you are sure they are fully recovered.

There is usually no need to call a doctor or an ambulance unless:

  • It is their first seizure.
  • Injury has occurred which cannot be dealt with.
  • The seizure does not stop after a few minutes. Status epilepticus is rare but means a seizure does not stop, or they keep recurring one after the other. This is an emergency and needs urgent treatment to stop the seizure.
  • There is difficulty with breathing.
Original Author:
Dr Tim Kenny
Current Version:
Peer Reviewer:
Prof Cathy Jackson
Document ID:
4436 (v41)
Last Checked:
05/06/2015
Next Review:
04/06/2018
The Information Standard - certified member
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