Dealing with a Tonic-clonic Seizure
Tonic-clonic seizures are a common form of epileptic seizure. This leaflet gives some tips on how a bystander can help. There are different types of epilepsy.
During a seizure
Seizures can vary enormously in their type and duration. The following is a guide to assist a person who is having a seizure.
- Note the time.
- Do - prevent crowds gathering round.
- Do - place a cushion or some clothing under the head to prevent injury.
- Do not - try to restrain the person. If there is a warning (aura) before a seizure, it may be possible to guide the person to a safe place or cushion the expected fall to the ground. When the seizure starts, do not try to hold the person upright, but let them lie down.
- Do not - move the person unless they are in a dangerous place (for example, in a road or next to a fire). If possible, move dangerous objects away from the person.
- Do not - place anything in the person's mouth, or try to move the tongue.
Once the seizure has stopped
- Do - roll the person on to their side into the recovery position.
- Do - check that breathing has resumed normally. It is normal for breathing to stop for a short while during the stiff (tonic) part of the seizure. The face will go pale or bluish. During the convulsive (clonic) part, breathing is irregular. After the seizure is over, breathing returns to normal. If not, check there is nothing stopping breathing such as food or false teeth. The recovery position helps saliva and anything in the mouth, such as food or sick (vomit), to drain out of the mouth and not back into the throat.
- Do - stay and talk to the person. Give reassurance until they are fully recovered. It may take a while for the person to wake up fully. Do not leave a person alone whilst they remain dazed or confused.
- Do not - offer something to eat or drink until you are sure they are fully recovered.
There is usually no need to call a doctor or an ambulance unless:
- It is their first seizure.
- Injury has occurred which cannot be dealt with.
- The seizure does not stop after a few minutes. Status epilepticus is rare but means a seizure does not stop, or they keep recurring one after the other. This is an emergency and needs urgent treatment to stop the seizure.
- There is difficulty with breathing.
Further help & information
New Anstey House, Gate Way Drive, Yeadon, Leeds, LS19 7XY
Tel: (Helpline) 0808 800 5050, (Admin) 0113 210 8800,
48 Govan Road, Glasgow, G51 1JL
Tel: (Helpline) 0808 800 2200, (Admin) 0141 427 4911
Chesham Lane, Chalfont St Peter, Buckinghamshire, SL9 0RJ
Tel: (Helpline) 01494 601400, (General) 01494 601300
Bradbury House, 23 Salisbury Road, Wrexham, LL13 7AS
Tel: (Helpline) 0800 228 9016, (Admin) 01978 312325
Further reading & references
- Epilepsies: diagnosis and management; NICE Clinical Guideline (January 2012)
- Diagnosis and management of epilepsy in adults; Scottish Intercollegiate Guidelines Network - SIGN (2015)
- Epilepsy; NICE CKS, December 2014 (UK access only)
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Tim Kenny
Dr Colin Tidy
Prof Cathy Jackson