Tonic Seizures


Muscle "tone" is the muscle's normal tension at rest. In a tonic seizure, the tone is greatly increased: the body, arms, or legs become suddenly stiff or tense.

  • A person may be aware or have only a small change in awareness during a tonic seizure.
  • They usually happen during sleep and usually involve all or most of the brain, affecting both sides of the body.
  • They are short, usually less than 20 seconds.
  • A person may fall if standing when a tonic seizure starts.

When it starts in one area of the brain:

Stiffening of a part of the body may begin in one area and stay local. These are called focal tonic seizures.

When it starts on both sides of the brain:

The whole body or both sides of the body may become stiff or tense from the beginning. These are called generalized tonic seizures.

  • Stiffening or other movements can be seen in other neurological problems, especially in children.
  • A written description or video of what happens during the seizure is very important. For example, tonic seizures start suddenly with forceful movements. Events that start more slowly may be due to another condition.
  • When a tonic seizure ends, the person may or may not be sleepy or confused.
  • Typically, no first aid is needed unless a person is not fully aware during or after the seizure.
  • Preventing injury is a key part of first aid for tonic seizures. Some people may need to wear protective equipment like a helmet to prevent head injuries from falls.

It depends and varies between people. Some people may have just one seizure and others may have tonic seizures that occur often or in clusters of many a day.

  • Seizure medicines are the main way of treating and preventing tonic seizures.
  • If seizures are not controlled with medications, other options may be possible, such as dietary therapies, devices, or even surgery.
  • Knowing where a seizure starts and what part of the brain is involved helps you learn what options may be possible.

If seizures are not controlled, seek out the help of an epilepsy specialist or visit an epilepsy center to explore treatment options.

If you think that you or your loved one may be having tonic seizures, talk to your doctor as soon as possible. Getting the correct diagnosis early can help lead to better treatment.

Authored By:

Elaine Kiriakopoulos MD, MSc
Patty Osborne Shafer RN, MN

on Monday, March 27, 2017

Reviewed By:

Joseph I. Sirven MD
Robert Fisher MD, PhD

on Monday, March 27, 2017


Epilepsy Centers

Epilepsy centers provide you with a team of specialists to help you diagnose your epilepsy and explore treatment options.


Epilepsy Medication

Find in-depth information on anti-seizure medications so you know what to ask your doctor.


Epilepsy and Seizures 24/7 Helpline

Call our Epilepsy and Seizures 24/7 Helpline and talk with an epilepsy information specialist or submit a question online.


Tools & Resources

Get information, tips, and more to help you manage your epilepsy.