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Fact sheet - Information from A&E following a first tonic-clonic (grand-mal) seizure

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If you have had one tonic-clonic seizure, you may never have another. However, it’s natural to worry that this might happen. This leaflet is to show your family, or carers, what to do, if you do have another tonic-clonic seizure. It also looks at other issues, such as safety, the driving laws, and work.

Your hospital will tell your family doctor that they have given you this leaflet.

What happens in a tonic-clonic seizure

You go stiff, lose consciousness and, if you are standing, fall to the ground. You have jerking movements and, because your breathing pattern has changed, might get a blue tinge around your mouth. You might lose control of your bladder, or bowels, or both. After a minute or two, the jerking stops and you will slowly return to consciousness.

First aid for tonic-clonic seizures

Remember ACTION for tonic-clonic seizures

A    Assess the situation – are they in danger of injuring themselves? Remove any nearby objects that could cause injury
C    Cushion their head (with a jumper, for example) to protect them from head injury
T    Time - check the time – if the seizure lasts longer than five minutes you should call an ambulance
I    Identity - look for a medical bracelet or ID card – it may give you information about the person’s seizures and what to do
O    Over - once the seizure is over, put them on their side (in the recovery position). Stay with them and reassure them as they come round
N    Never restrain the person, put something in their mouth or try to give them food or drink

Person in recover position

Call an ambulance if:

  • You know it is the person’s first seizure, or
  • The seizure lasts for more than five minutes, or
  • One seizure follows another without the person gaining consciousness between seizures, or
  • The person is injured, or
  • You believe the person needs urgent medical attention

Some people need to rest for a few minutes after a seizure. Others may need to sleep for some time.

Epilepsy Action has a two-minute video that gives first aid information based on the ACTION message.

Driving – the law

If you have a driving licence, you should stop driving and inform your driving agency. If you live in England, Scotland or Wales, this is the Driver and Vehicle Licensing Agency (DVLA). If you live in Northern Ireland, it is the Driver and Vehicle Agency (DVA). You should not drive until your driving agency says you can.


Because there is some risk that you could have another seizure, it makes sense to think about safety. This doesn’t mean you will have to stop doing all the things you usually do. But it may mean putting things in place to keep risks to a minimum. Here are some examples.

  • If you are having a bath or shower, consider having someone with you, or just outside the door, checking that you are safe.
  • If you have free-standing heaters, try to place them where they are least likely to be knocked over during a seizure.
  • Try to avoid placing your bed against a wall or next to a radiator. This can prevent you knocking your limbs on the wall, or burning yourself, on the radiator during a tonic-clonic seizure.

Seizure triggers

There are some things – triggers - that make seizures more likely for some people. However, not everyone has a trigger for their seizures. Common triggers are stress, lack of sleep, or drinking large amounts of alcohol.


Depending on the type of work you do, you may need to take some precautions for a while. Talk to your manager, to make sure you are as safe as possible at work and are not breaching any health and safety regulations.

Hospital appointment

You may be referred to a specialist to see if a cause for your seizure can be found. When you go to your appointment, if possible take someone with you who saw your seizure.

Epilepsy Action has more information about driving, safety, seizure triggers, alcohol and work

Our thanks

Epilepsy Action would like to thank Margaret Jackson, Consultant Neurologist at Royal Victoria Infirmary, Newcastle, for her contribution to this information. Margaret Jackson has declared no conflict of interest.

Epilepsy Helpline

Freephone 0808 800 5050, text 0753 741 0044, email helpline@epilepsy.org.uk, tweet @epilepsyadvice
Code: GP09.01; Last Updated: May 2013; Due for Review: May 2015.

Contact details

Epilepsy Action, Gate Way Drive, Yeadon, Leeds LS19 7XY, UK, +44 (0)113 210 8800. A registered charity (No. 234343) and company limited by guarantee (No. 797997) in England.© Copyright Epilepsy Action
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Comments: read the 2 comments or add yours


are you still allowed to drive if you only have seizures while sleeping I have {gran mal } seizures but never awake and are mostly controlled with 2 x 500mg epilum

Submitted by mike on

Hi Mike,

If you have seizures when you are asleep, you are allowed to drive when:

  • You have been seizure free for 12 months or
  • You have been having sleep seizures only for at least 12 months, and you have never had seizures while awake or
  • You have had awake seizures in the past, but you have been having sleep seizures only for at least three years.

 You must also meet the following conditions: 

  • As far as you are able, you follow your doctor’s advice about your treatment and check-ups for epilepsy and
  • The driving agency is satisfied that as a driver you are not likely to be a source of danger to the public.

If you meet these rules you can apply for your first driving licence or re-apply for a licence.

I hope this information helps. If you want to talk through anything feel free to contact us on the Epilepsy Helpline freephone 0808 800 5050.

Epilepsy Action Advice and Information Team

Submitted by Grace, Epilepsy... on

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