Grand Mal Seizure Overview

Grand Mal Seizure

According to, Epilepsy is a characteristic of various brain diseases. It manifests itself in seizures, and the most common type of seizure is called a grand mal seizure.

What is a grand mal seizure?

The word “epilepsy” comes from ancient Greek, “epilepsis” means attack or attack. This makes it clear how suddenly and unpredictably such a seizure occurs in the brain and puts those affected out of action. Science distinguishes different types of seizures.

They differ on the one hand by the brain region in which they originate and on the other hand by their strength. There are convulsions without or with very brief disturbances of consciousness (petit mal seizures), with and without jerks of the extremities and tonic-clonic seizures with profound loss of consciousness, spasms and severe convulsions – the grand mal seizures.


The causes of epilepsy are very different. Brain damage, for example due to a lack of oxygen at birth, is just as possible as malformations of the brain tissue or blood vessels. But infectious diseases, inflammatory processes in the brain, poisoning, drug use, electric shock and various metabolic disorders can also trigger epilepsy.

With the right inclination, there are sometimes very banal triggers, for example flickering lights in a disco, loud noises. Excited , sleep deprived, or breathing too quickly. Sometimes, however, the treating physicians do not find any clues to the sudden discharges in the brain that lead to seizures of all kinds.

Symptoms, Ailments & Signs

As a rule, the grand mal seizure proceeds as follows: In the first phase, those affected feel a kind of anticipation, a special feeling of discomfort. Experts call this an aura. In the second, the tonic phase, they completely lose control of themselves, become totally stiff and pass out. If it is no longer possible to lie down, many of those affected fall and can seriously injure themselves.

In the clonic phase that follows, there are uncontrollable jerking of the arms and legs, and some of those affected also bite their lips and tongue until it bleeds. In the subsequent recovery phase, those affected are in a kind of deep sleep. The entire grand mal seizure can last from a few seconds to a few minutes to hours.

Affected persons can neither influence the course of the seizure nor the duration of the seizure in any way. However, relatives, friends or bystanders can help with a grand mal seizure. The possibilities for help are limited. Helpers can only try to ensure that the patient does not fall as badly as possible and does not hit obstacles and objects during the convulsions and injure himself.

You should also make sure that he gets enough air during the recovery phase. It may therefore be necessary under certain circumstances to bring him into the stable side position. Anyone who experiences a grand mal seizure in someone they do not know should always call an ambulance as a precaution. Relatives can assess whether this is necessary or whether it is sufficient to wait for the seizure to end.

There are also some emergency medications that work for long-lasting seizures that family members can give to those affected if instructed to do so by the doctor treating them. Under no circumstances should one leave those affected alone in this completely helpless situation.


In order to diagnose epilepsy, the seizure pattern must be analyzed in detail. The statements of witnesses who witness it are also important, because the person concerned usually does not notice anything about the attack. In addition, magnetic resonance imaging (MRI) is required.

With it, the doctor can determine whether there is a structural change in the brain. Computer tomography and electroencephalography may also be necessary, in special cases also magnetic resonance imaging, angiography and cerebrospinal fluid puncture.


The grand mal seizure leads to an epileptic seizure. This can result in extreme consequential damage and complications for the patient. These depend heavily on the respective situation and the well-being of the patient.

Discomfort usually precedes the seizure and continues to cause loss of control. The affected person stiffens and in most cases can no longer move. Shortly thereafter, fainting occurs. When the patient loses consciousness, he or she may fall or be hit, which can lead to various complications.

These can also occur if the person is driving or working on dangerous machinery at the time of the grand mal seizure. The grand mal seizure itself cannot be treated, so the patient can only be placed in a stable position. In addition, fellow human beings can hold the patient in the event of a fall, so that no injuries occur.

Usually there are no complications. Furthermore, the epileptic seizures are limited in time, although no precise prediction can be made when the next seizure will occur.

When should you go to the doctor?

A grand mal seizure is an epileptic seizure in which the affected person loses control of their own body. However, this clinical picture can occur in different degrees of severity, so that medical treatment is not always necessary.

Mild and initial seizures usually manifest themselves as a simple muscle twitch. Immediate treatment by a doctor is not necessary in such a case. However, the uncontrolled muscle twitching should still be observed so that it does not lead to further complications or discomfort.

If the epileptic seizures lead to a total loss of control, then a visit to the doctor should not be postponed. Drug treatment is absolutely necessary in such a case to prevent serious consequential damage.

In addition, this is the only way to diagnose or rule out a serious underlying disease. The following therefore applies: A grand mal seizure is a serious clinical picture that should definitely be treated by a doctor. Complications and aggravations can only be avoided if the affected person consults a doctor as quickly as possible.

Treatment & Therapy

One cannot really speak of a cure for epilepsy. However, according to detailed studies, between 50 and about 80 percent of all those affected achieve complete freedom from seizures, or at least freedom that lasts for many years. Whether the epilepsy will disappear again cannot be predicted with certainty, as too little is known about the triggers.

But there are still things that both those affected and their doctors can do to reduce the frequency of epileptic seizures, and sometimes to make them disappear altogether. Just abstaining from drugs and alcohol, getting enough sleep, learning relaxation techniques, a certain type of diet, and a healthy lifestyle in general can be helpful.

Doctors may also initiate drug therapy. There are several types of so-called seizure blockers today. However, their effect is imprecise and they sometimes have very unpleasant side effects. Such medication must therefore be carried out with a precise risk/benefit assessment and the most precise dosage.

In the case of very frequent and long-lasting seizures and a very severe impairment of the quality of life, there may also be the possibility of electrical stimulation of the vagus nerve. He suffers excitations in the brain further and can thus alleviate certain types of seizures or at least reduce their frequency.

In some cases there is also the possibility of a surgical intervention. However, this is only possible if there is brain or vascular damage that can be precisely localized. In addition, such an operation is very risky.

Outlook & Forecast

The prognosis of a grand mal seizure depends on the circumstances and environment in which it occurs. Therefore, various complications can occur, which in the worst case can lead to death. The risk of falling with subsequent serious physical injuries in the form of broken bones is increased.

Seizures during pregnancy are dangerous for both mother and baby, and certain antiseizure drugs increase the risk of birth defects. People with grand mal seizures are more likely to have mental health problems, such as depression and anxiety. These problems can also be the result of complications related to the condition itself as well as drug side effects.

The earlier medical treatment is initiated, the better the prognosis. The shorter the time between the first attack and adequate drug treatment, the better the prognosis. The classification made here with its subgroups is just as important. Children between the ages of one and fourteen have the best chance of achieving near-complete rehabilitation.

Here, too, the classification of the different gradations and the frequency of seizures is important. Mere absent-mindedness, called absences, disappear completely in the course of adolescence. The recurrence rate in children with grand mal seizures is around 12% if they are at least three years old.


Epilepsy and especially the occurrence of grand mal seizures is a serious condition and can significantly reduce the quality of life of those affected. But it is not a fatal disease and with the right knowledge and support and understanding of the environment, one can live with it in a relatively normal way.


After the first grand mal seizure, intensive follow-up care is absolutely necessary. As soon as the medical first aid has been completed and the condition of the person concerned has stabilized, intensive examinations for precise epilepsy diagnostics are necessary. These can sometimes last for several days and are usually accompanied by inpatient hospital stays.

Lifelong follow-up is necessary to adjust to optimal drug treatment of the underlying form of epilepsy. Initially, the check-ups are carried out at very short intervals several times a month. They usually become less common over time, depending on the success of drug therapy.

If further grand mal seizures or other physical complaints occur, even more intensive follow-up care is necessary. In general, it is advisable to attend all follow-up and check-up examinations. To be on the safe side, further examinations can also be carried out at the request of the person concerned.

If the patient remains seizure-free for a longer period of time, the intervals for medical check-ups can be reduced. However, this must be clarified with the doctor treating you. In the case of those affected with a known epilepsy diagnosis who suffer a repeated grand mal seizure, it is also advisable to have several medical check-ups after the first medical aid.

You can do that yourself

The disruption of both hemispheres of the brain triggers generalized seizures in epileptics. The development phase is accompanied by harbingers of a seizure. The patient is irritable, upset and suffers from headaches. Other physical signs include tingling in the hands and legs and hearing loss.

The perception and classification of symptoms is important for epileptics. The triggering of a grand mal seizure is individual for each patient. Seizure self-monitoring gives the patient information about their own course of the disease. Epileptics who actively deal with their illness learn to avoid seizure situations. Stress is known to be a recurring seizure trigger.

Recognizing it as a trigger makes it possible to take effective countermeasures. Active relaxation exercises break up the run-up. Seizure self-control can be learned and is carried out over a longer period of time. The duration of the rhythm of the seizures that occur is dependent. Good body awareness is required. Self-observation is an adjunct to drug treatment.

Communication with the social environment is important for chronic epileptics. A grand mal seizure is difficult to assess and frightening for family members. Information about the phases of a seizure and what measures to take will help those affected.

Grand Mal Seizure