What to expect for a tonic-clonic or grand mal seizure: The person's body will lock up. Their arms and legs will be stiff and there will be a body jerking and flailing about possibly. Their face will be contorted and due to lack of oxygen will turn color. Their eyes may flutter, roll up, stay closed or be wide open and the pupils may be dilated so big you cannot see the color or their eyes. At this time they cannot see or breathe, however they may be able to hear. Speak to them gently and remain as calm as possible.
Get the person to the floor as gently as possible and clear all objects that may be in the way. Put something soft under their head and roll them to their side. They may vomit and this will cause choking. If the person has a history of seizures and it did not last longer than 5 minutes it is not necessary to call 911. However, if this is their first time or if they start to come out of it and go into another or if any broken bones have occurred call 911.
Do not put anything in their mouth. This procedure is no longer protocol. It may cause choking, damage to the person having the seizure or damage to the person trying to put something in their mouth. Put something soft under their head. Do not try to hold their body or head still. Just move objects around them and try to keep them rolled on their side to prevent choking if they vomit. They may lose consciousness. If you can take note how long the seizure lasts. This information is important for evaluation from their physician.
When they start to come out of the seizure, talk in a calm tone. Ask them their name, day of week or hold up your fingers and have them tell you how many fingers you are showing them. Help them sit up when they can. Do not rush them. Answer any questions they may have. This type of seizure is very harsh on the system. They may have lost control of their bladder and they will be wondering how they wet themselves and how they got on the floor. It is important for to get as much information as they can to relay on to their physician.
Milder seizures consist of eyes fluttering and involuntary body movement, numbness of a body part, loss of memory, visual changes. Seizures can last a few seconds or continuous ones that do not stop without intervention. Some people are able to tell when a seizure is about to happen. They are familiar with some of their symptoms and let those around them know before the seizure comes on. They may be disorientated and tired when the seizure it over.
A person who has had a tonic-clonic seizure should call their doctor immediately or go to emergency. Under no circumstances should they drive before they have been checked out by a physician.