When someone has a tonic-clonic seizure, their muscles stiffen and jerk. They're not aware of what's going on around them. Your child will need to see a neurologist (a doctor who treats problems with the brain and spinal cord) to find out what caused the seizure and what treatment is needed. Not every child who has a seizure has another. Some kids outgrow their seizures.

Parents can help by following the health care provider's instructions and learning how to keep their child safe during a seizure.

• Your health care provider will help you create a plan for your child and talk to you about:
  • what medicines your child should take
  • if any "triggers" (such as fever, flashing lights, lack of sleep, or medicines) can make a seizure more likely
  • precautions your child should take while swimming (never swimming alone), bathing (showers only, no baths, and keep the bathroom door unlocked), or riding a bike (always wear a helmet and never bike alone)
  • if it's OK for your teen to drive
  • whether your child needs to wear a medical alert bracelet
  • keeping a record of your child's seizures including when they happen, how long they last, what happened right before the seizure, and what happened during and after the seizure
  • following up with a neurologist 
• Make sure the school nurse and teachers know about your child's seizures.
• If your child has another seizure:
  • Gently lower your child to the floor.
  • Put your child on their side to prevent choking.
  • Put something small and soft under your child's head.
  • Move sharp or breakable objects out of the way.
  • If your health care provider prescribed medicine to stop the seizure, give the medicine as directed. But don't try to give your child any medicine (pills or liquid), food, or drinks by mouth until they're fully awake.
  • Don't try to hold or restrain your child.
  • Don't put anything in your child's mouth. Your child won't swallow their tongue.
  • Loosen tight clothing.
  • Stay with your child during the seizure. If the seizure lasts more than 5 minutes, ask someone to call 911.
  • When the seizure is over, let your child rest as needed.

Your child:

• has more seizures or seizures that seem different

Your child:

• has a seizure lasting more than 5 minutes or has repeated seizures
• seems to be having trouble breathing or turns a bluish color
• falls or is injured during the seizure
• is unconscious for longer than a few minutes after a seizure
• is taking medicine and has side effects such as a rash, belly pain, sores around the mouth, sore throat, easy bruising or bleeding a lot, or fever

What is an aura? An aura is a warning sign or first symptom of a seizure. During an aura, a child might have:

• déjà vu (a feeling of already having been in this situation)
• an unusual smell or taste
• visual symptoms, like seeing flashing lights
• sudden, intense emotion (such as fear)
• nausea or a rising sensation in the stomach

What happens after a seizure? After a generalized tonic-clonic seizure, a child may feel confused, irritable, or tired, and have a headache or other symptoms. This is called the postictal (post-IK-tul) phase. It usually lasts just a few minutes, but it can be longer.

What causes a tonic-clonic seizure? Sometimes tonic-clonic seizures are genetic (run in families). Other causes include:

• brain injury, tumor, or infection 
• severe electrolyte imbalances (for example, low sodium in the body)
• drug or alcohol use or withdrawal
• genetic changes (called mutations)
• some medical conditions

Sometimes what causes the seizures is not known.

How are tonic-clonic seizures treated? Depending on what's causing them, tonic-clonic seizures may be treated with:

• medicines
• a special diet (such as the keto diet, which is a high-fat, low-carbohydrate diet) 
• vagus nerve stimulation (a device sends electrical impulses to the brain)
• surgery