Generalized Seizures


What is a generalized seizure?

Seizures occur when nerve cells in the brain send out sudden, excessive electrical signals.
Unlike focal seizures, generalized seizures are not limited to just one area of the brain. They involve nerve cells on both sides of the brain at the same time.

What are the symptoms?

A child has no warning before a generalized seizure starts. Just before it happens there may be a change in behavior, such as being irritable or feeling restless. Once the seizure starts, the child normally loses awareness of his or her surroundings.

The types of generalized seizures are explained below:

  • Clonic seizures involve repeated bilateral (both sides) rhythmic jerking of the child’s muscles that appears as the body stiffening and relaxing in a rhythmic way. They cannot be stopped by restraining or repositioning of the arms or legs.
  • Tonic seizures involve increased muscle tone (stiffening) of a muscle or a group of muscles on both sides of the body lasting for seconds to minutes.
  • Generalized tonic-clonic seizures (commonly called grand mal seizures) are characterized by a tonic and a clonic phase, usually in this order.
  • Myoclonic seizures appear as a single or series of continuous jerks. Each myoclonic jerk is usually sudden and very brief. They could involve the whole body or be more  limited to the face, trunk, arms or legs. Unlike other generalized seizures, your child may be aware of his/her surroundings during jerks.
  • Absence seizures (previously known as petit mal seizures) involve brief, sudden arrest of activity and unresponsiveness. It may come on quickly, last for a few seconds then your child recovers right away. During the seizure, your child simply stares in space. It may be associated with eye blinking or other facial movements. When the seizure is over, your child may continue with what he or she was doing before the seizure but may not recall what occurred during the seizure.
  • Atonic seizures involve sudden loss of muscle tone. If your child is standing, this sudden loss of tone can result in a “drop attack” (other causes of drop attacks include myoclonic and tonic seizures). Atonic seizures may be followed by a brief period of confusion.

What can you do?

The most important thing is to stay calm. Absence, myoclonic and atonic seizures usually last only a few seconds. Tonic-clonic, clonic and tonic seizures usually last a few minutes. Seizures do not usually cause brain damage unless they last for over 30-60 minutes. Stay calm and follow these steps:

  1. Place your child on a soft surface, lying on their side.
    Do not restrain the child and do not put anything in their mouth.
  2. If your child vomits, turn them on their side. This will help keep the airway clear.
  3. Remove any furniture or sharp objects from the area.
  4. Look to see exactly how your child moves and how they respond to you so you can describe it later.
  5. Time how long the seizure lasts:
  • If the seizure lasts more than 5 minutes, call 999 right away for emergency services. Medicine can be given by the emergency medical team to stop the seizure 6. If your child loses color in their face (turns blue) for more than 3 minutes, call 999.

After the Seizure:

Your child may be a little irritable or not their usual self for a day or more, but this is maybe related to his or her illness. There is no need to change your lifestyle or the way you care for your child.

  • Your child can safely sleep in their own bed or crib
  • Remove extra pillows and soft toys from the bed. For a toddler, use guard rails on the bed • If your child continues to be sick and has other signs of illness, continue to follow the doctor’s advice

How is it prevented?

Prevention of a seizure will depend on the cause. Medicine can help, but some children may still have seizures. If the doctor gives your child medicine, it is important that you give your child the medicine as instructed. It is also important to avoid seizure triggers such as sleeping late at night. Certain generalized seizures are also triggered by flashing lights which should also be avoided.
If your child has a seizure, there are things you can do to keep your child safe. The main goal is to protect your child from injury.

Call Emergency Services (999) if:

  • The seizure lasts more than 5 minutes
  • The seizure causes any problems with breathing
  • Your child injured their head during the seizure
  • Your child has 2 seizures in a row, without much time between them
  • Your child has a seizure and does not wake up after the seizure stops
  • Your child has a seizure and is very confused after