When people have tonic-clonic seizures, they are not aware of what’s going on around them. These seizures may require first aid including making certain that the person is breathing and there are no injuries.
The tonic phase comes first: All the muscles stiffen. 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.
After the tonic phase comes the clonic phase: 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.
After the seizure has occurred, the person may be sleepy or confused for several minutes or longer. They may have lost bowel or bladder function. They also may have bitten their tongue.