Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis
A seizure is caused by abnormal signals in the brain. This may be brought on by a head injury, stroke, brain infection, or tumor, but more than half the time the cause is unknown. During a grand mal seizure, patients may lose consciousness as well as bowel and bladder control. They may stop breathing or may become injured during the severe muscle contractions.

Living With Your Diagnosis
Grand mal or tonic-clonic seizures are characterized by four phases. Recognizing these may be important. Grand mal seizures are often preceded by an odd feeling, strange taste or odor, or headache. These warning signs are known as auras (phase 1). Not all grand mal seizures are preceded by an aura. This type of seizure generally begins with a rigid stiffening of the body, lasting a minute or less, and loss of consciousness. This is known as the tonic phase (phase 2). This is followed by the tonic-clonic phase that appears as strong muscle contractions and convulsions (phase 3). The tonic-clonic phase may last several minutes. A tonic-clonic seizure generally causes a loss of consciousness, vigorous muscle contractions, and loss of control of your bladder and/or bladder. Persistence of tonic-clonic seizure activity is a medical emergency called status epilepticus. Immediately after the seizure is the postictal phase where the patient gradually returns to consciousness from a level of stupor and confusion (phase 4). When epilepsy is newly diagnosed, you must take several precautions until you have confidence that your seizure disorder is well controlled. If you live alone, you should make arrangements for someone to stay with you until your physician believes it is safe for you to resume living alone.

Initially, your physician may want to get a computed tomography (CT) scan of your brain and a brain wave study (electroencephalogram, [EEG]) to determine whether there is a known cause for your seizures. The primary treatment for seizures is medication. Sometimes more than one antiseizure
(anticonvulsant) medication may be used. Your physician may have to obtain blood samples at times to ensure that you are receiving the correct dose of medication. Your dose schedule may be adjusted to achieve a protective blood level of medication. There are several different medications that may be used, and your physician will give you information about the side effects associated with each medication prescribed. Often, the medication will decrease the frequency and severity of the seizure but some individuals, despite medication, continue to have seizures.

The DOs
• Take your medication as prescribed to prevent seizures.
• Wear an ID bracelet indicating that you have a seizure disorder and listing the medications you are taking.
• Teach your family and friends about your disorder and what to do if you have a seizure.
• If you feel a seizure coming on, tell someone near you and lie down.

The DON’Ts
• Don’t operate dangerous machinery or drive unless your physician has approved.
• Don’t swim alone.
• Don’t climb on ladders or roofs or anything that may be dangerous should you have a seizure.

When to Call Your Doctor
• If the patient is injured during a seizure, has difficulty breathing, or does not regain consciousness shortly after the seizure.
• If the patient has continuous tonic-clonic seizures. This is a medical emergency called status epilepticus. Call “911” for an ambulance.
• If you have any problems associated with your medications.
• If your seizures become more frequent or severe.