What is it like to have a Focal to Bilateral Tonic-Clonic Seizure and how can I tell if someone is having one?
These seizures are dramatic cannot be missed due to their sudden and forceful nature. They may begin with an aura or focal aware seizure or they may begin with a focal impaired awareness seizure that continues and changes into the bilateral tonic-clonic seizure.
The bilateral tonic-clonic part begins usually with stiffening of the muscles. Air being forced past the vocal cords causes a cry or groan. The person loses consciousness and falls to the floor. The tongue or cheek may be bitten, so bloody saliva may come from the mouth. The person may turn a bit blue in the face. The bilateral tonic-clonic, convulsive phase of these seizures usually lasts no more than a few minutes.
After the tonic phase comes the clonic phase. The preceding focal onset seizure is usually very brief, and is often hard to detect. The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees. After a few minutes, the jerking slows and stops. Bladder or bowel control sometimes is lost as the body relaxes. Consciousness returns slowly, and the person may be drowsy, confused, agitated, or depressed.
It may be difficult to distinguish these seizures from Generalized Onset Tonic-Clonic Seizures, especially if they occur during sleep or are not seen by anyone else. Most convulsive seizures during sleep are Focal to Bilateral Tonic-Clonic Seizures.