Tonic-Clonic Seizures for the Elderly Explained

Some of the most common symptoms of epilepsy are seizures – uncontrollable bursts of electrical activity that scramble the brain's signals. These sudden fits affect everyone differently, depending on what part of the organ is involved. Some patients collapse, thrash and jerk, whereas others disassociate and stare blankly into space (this is especially common in children). As such, the condition can be tricky to diagnose and treat.

You might be surprised to know there are countless types of seizures, including tonic-clonic (previously known as grand mal seizures), complex partial and simple partial. While this guide predominantly focuses on the former – as they're the most common – we'll also briefly explore some of the others so you can tell the difference in an emergency.

What are the types of epileptic seizures in adults?

Before diving into tonic-clonic seizures, it's helpful to understand the main types of fit people with epilepsy might experience. This way, you'll know exactly what you're up against if you or a loved one has been diagnosed.

Usually, seizures are separated into two categories: generalised seizures that affect both sides of the brain and focal or partial seizures that affect one side of the brain.

Generalised seizures

Tonic-clonic seizures

Tonic-clonic convulsions are what we typically associate with epilepsy. There are two phases (which we'll break down in more detail later) – the tonic phase, where a person loses consciousness, and the clonic stage, where a person violently fits. Experts believe around 25% of all patients suffer from this type of seizure.

Thankfully, most people live happy, independent lives with tonic-clonic seizures, especially if they invest in at-home safety precautions like personal alarms with fall detection. These can be especially effective for senior citizens.

Absence seizures

Absence seizures are pretty self-explanatory – a person briefly loses awareness of their surroundings and stares blankly into space. They can occur up to 30 times a day and last for 15 seconds each time. The sufferer won't remember anything from this time period.

Focal or partial seizures

Simple partial or “auras”

Simple partial seizures trigger unusual symptoms. Many call them "auras" because they usually indicate another type of fit is imminent. You might experience butterflies, an eerie feeling of déjà vu, extreme anxiety or joy, twitches and stiffness.

Complex partial

Here, people make random movements, such as lip-smacking, flailing and chewing. You can't "snap someone out" of this. In fact, restraining someone during any type of seizure can be dangerous.

What are the types of epileptic seizures in children?

Parents often wonder whether tonic-clonic seizures are paediatric. The answer is yes – children experience the same kinds of attacks as adults, although some are more common in childhood.

Children between 4 and 12 years often have absence seizures, which are difficult to distinguish from normal daydreaming. Sometimes, caregivers and healthcare professionals mistake the symptoms for developmental delays or behavioural problems.

Infantile spasms and febrile seizures are child-specific. The former affects babies up to 6 months and can happen over one hundred times a day, causing serious long-term complications. The latter are triggered by high temperatures and fevers.

What causes tonic-clonic seizures?

Researchers aren't entirely sure what causes tonic-clonic convulsions, but they know it's something to do with overstimulation in the brain. A bolt of powerful, spontaneous electrical activity sparks uncontrollable movements and worrying behavioural changes. Moreover, seizures can be completely random, part of a repeated, chronic illness or caused by psychological problems – they're not confined to epilepsy.

Nevertheless, you're at a higher risk of developing tonic-clonic fits if you have or have had any of the following:

• Brain infection
• Brain tumour
• Head trauma
• Stroke or mini-stroke
• Lack of oxygen at birth
• Drug or alcohol abuse
• Dementia

While episodes appear to be random, you might notice certain catalysts that increase their frequency, such as stress and poor sleep (despite what we're told, flashing lights don't usually have an impact). We suggest keeping a tonic-clonic diary to help you predict and better manage your seizures.

What are the early signs of a tonic-clonic seizure?

You'll be pleased to know you can generally spot the early signs of a tonic-clonic seizure. This is actually where simple partial seizures or "auras" help – you might start to feel an unusual, rising feeling in your stomach, intense anxiety and tingling or twitching in your limbs.

Surprisingly, many of the early signs of tonic-clonic seizures are usually emotional. Many experience overwhelming fear or joy. Some report strange smells, tastes and sounds. The more familiar you become with your symptoms, the better you'll be able to manage them.

If you notice any of these red flags, lie on your side in a comfortable space with no hard or sharp objects nearby. You could also invest in a personal safety alarm that contacts friends or family in an emergency.

What are the stages of a tonic-clonic seizure?

As mentioned, there are two stages of a tonic-clonic seizure – the tonic stage and the clonic stage. Let's take a closer look at some of the symptoms a person might experience in each.

Stage one: Tonic

The tonic stage is distinguished by stiffening – this can happen quickly and without warning. At the same time, sufferers lose consciousness, fall to the floor and often bite down on their tongues. This can be incredibly distressing to witness, let alone go through. Tight chest muscles make breathing visibly difficult, and people often turn blue or grey. There may also be foam or blood around the mouth.

Stage two: Clonic

After collapsing, the clonic stage begins. People lose control of their limbs and start to fit uncontrollably – how you probably imagine when you think of typical epileptic seizures. On top of this, breathing is still laboured, and many lose control of their bladder and bowel.

Of course, it's unbelievably frightening when a tonic-clonic seizure hits, especially when you're alone. The good news is you can take precautionary measures to give yourself extra peace of mind. The SureSafeGO 24/7 Connect will automatically alert a fully trained Monitoring Centre operative when a fall is detected. That’s paired with GPS tracking, so people always know where you are – making it ideal for use at home, in the garden or out and about.

What to do if someone has a tonic-clonic seizure

Knowing what to do when someone experiences a tonic-clonic seizure can save lives. Our top advice? Try to stay calm and focused. Experts also suggest you time the convulsion to better understand what you're dealing with. Typical episodes last between up to 3 minutes, and anything over 5 minutes is an emergency – call 999 straight away.

Make the environment safe

Hopefully, your loved one will recognise the warning signs of a tonic-clonic seizure, so you can quickly get them to a safe environment. Cover sharp objects like table corners, loosen restrictive clothing and remove eyewear and jewellery. Gently help the person to the floor before they collapse.

Understandably, it can feel embarrassing to wake up to a huge crowd of concerned faces. As such, keep onlookers away and do what you can to maintain your friend's privacy.

Turn the person onto one side

Contrary to popular belief, it's physically impossible for someone to swallow their tongue. Nevertheless, lying on one side is the safest position for tonic-clonic seizures because it eases breathing. Angle the person's head towards the floor, so saliva and blood can drain from the mouth.

During the tonic phase, it may look like your loved one has stopped breathing. However, this is usually down to the chest muscles tightening. As the seizure ends, everything will relax and return to normal.

Don't use restraints

Resist the temptation to try and stop the seizure. Although it might feel like the most natural solution, it can cause injuries and make the person more aggressive. There's nothing you can do besides secure the environment, stand back and wait it out.

Give reassurance and support

Coming around from a tonic-clonic seizure is overwhelming and confusing – not to mention painful. When your loved one is fully conscious, let them know they're safe, explain what happened and answer their questions. Stay with them until they're ready to get up and continue their activities.

Can tonic-clonic seizures be cured?

So, are tonic-clonic seizures curable? The answer isn't clear-cut, and treatments vary. For some, one medication is enough to prevent episodes. For others, doctors will prescribe a programme of drugs, surgery, nerve stimulation and dietary changes (the ketogenic diet was originally designed to help epileptic patients manage their symptoms).

However, healthcare professionals don't immediately treat unprovoked, first-time convulsions because they usually disappear by themselves. For instance, many children who have tonic-clonic seizures eventually outgrow the condition. Patients who haven't had an attack for a year can often slowly come off their medicine.

Quite simply, it's entirely possible to be seizure-free, although experts can't predict when or how this will happen.

Live confidently with a SureSafe Alarm

SureSafe alarms can help elderly people, and others suffering from tonic-clonic seizures to feel more confident in their everyday lives. Alarms with fall detection are especially helpful because they'll immediately alert a fully trained operator, friend or family member in an emergency.

Got any questions? Contact our professional, friendly team today on 0800 112 3201, request a call back or use our live chat.