Tonic seizure first aid

Depending on the type of epilepsy the person has, tonic seizures might be more likely to happen when they are asleep.

During a tonic seizure, a person’s muscles will stiffen. This can happen on one side or both sides of the body, depending on the part of the brain affected.

If they are not already lying down, they might fall down.

Their lips might turn blue and appear to stop breathing. This is because their chest muscles stiffen.

Tonic seizures are short, usually lasting less than 60 seconds. Some people tend to have clusters of tonic seizures, where they have several seizures in a short space of time.

The person’s neck will extend, their eyes open wide and roll upwards. Their arms may raise upwards and the legs might stretch or contract.

How to help

 You should:

• Protect the person from injury (remove any harmful objects from nearby)
• Time the seizure
• Stay with them until they have fully recovered
• Be calm and reassuring

Other advice

It’s important that you don’t hold the person down or move them unless they are in danger. You shouldn’t try to bring them round, and never give them anything to eat or drink until they are fully recovered. They might feel groggy for a few minutes, especially if they have had a cluster of seizures.

If a tonic seizure stops by itself and the person isn’t injured, they won’t usually need medical help.

Call for an ambulance if:

• A seizure lasts longer than 5 minutes
• One seizure follows another without them recovering in between
• They are badly injured during the seizure

If someone has had their first tonic seizure, they might not need medical help at the time. But they should make an appointment to see a doctor who can decide if any tests or a referral to a specialist are needed. We have more information on our diagnosis page.