From the Guidelines
A grand mal seizure is a specific type of seizure, also known as a tonic-clonic seizure, and is not different from "normal" seizures, but rather one of the most severe and recognizable types. Seizures come in many forms, with grand mal being characterized by both tonic (muscle stiffening) and clonic (rhythmic jerking) phases, often resulting in loss of consciousness, tongue biting, and loss of bladder control, and typically requiring 10-30 minutes for recovery 1. In contrast, other seizure types may involve more limited symptoms such as brief staring spells (absence seizures), localized muscle twitching (focal seizures), or unusual sensations without loss of consciousness. These differences occur because seizures vary in which brain regions are affected and how electrical activity spreads.
Some key characteristics of seizures include:
- Generalized tonic-clonic seizures affect large areas or both sides of the brain and manifest as full-body rhythmic jerking with alterations in consciousness 1
- Focal seizures affect only one area of the brain and can present as jerking of only one extremity or one side of the body, abnormal facial movements, small repetitive movements, or staring spells (focal impaired awareness), with or without changes in consciousness 1
- Seizure duration can be seconds to hours, and most seizures are followed by a postictal period in which the person appears tired and confused for several minutes 1
For someone witnessing a grand mal seizure, they should ensure the person's safety by:
- Moving dangerous objects away
- Placing something soft under their head
- Turning them onto their side
- Never restraining them or putting anything in their mouth Medical attention is necessary if the seizure lasts more than 5 minutes, the person doesn't regain consciousness, they have difficulty breathing, or it's their first seizure 1.
From the Research
Seizure Types
- A normal seizure, also known as a partial or focal seizure, is a type of seizure that affects only one part of the brain 2.
- A grand mal seizure, also known as a generalized tonic-clonic seizure, is a type of seizure that affects the entire brain and can cause loss of consciousness and convulsions 3.
Key Differences
- The main difference between a normal seizure and a grand mal seizure is the extent of brain involvement, with grand mal seizures affecting the entire brain and normal seizures affecting only one part of the brain 2.
- Grand mal seizures are often more severe and can cause more significant symptoms, such as loss of consciousness, convulsions, and muscle contractions 3.
- Normal seizures, on the other hand, may cause less severe symptoms, such as numbness, tingling, or muscle twitching, and may not always cause loss of consciousness 2.
Treatment Options
- The treatment options for normal seizures and grand mal seizures may differ, with grand mal seizures often requiring more aggressive treatment, such as hospitalization and emergency medication 4.
- Antiepileptic drugs, such as valproate, lamotrigine, and phenytoin, may be used to treat both normal seizures and grand mal seizures, but the specific medication and dosage may vary depending on the individual patient and the severity of their seizures 5, 3, 6.
Efficacy of Antiepileptic Drugs
- Studies have shown that different antiepileptic drugs may have varying levels of efficacy in treating normal seizures and grand mal seizures, with some drugs being more effective for certain types of seizures 2, 3.
- For example, valproate has been shown to be effective in treating generalized tonic-clonic seizures, while lamotrigine and levetiracetam may be more effective for treating partial seizures 3.