Tonic-Clonic Epilepsy (Epilepsy, Tonic Clonic)

A generalized seizure disorder characterized by recurrent major motor seizures. The initial brief tonic phase is marked by trunk flexion followed by diffuse extension of the trunk and extremities. The clonic phase features rhythmic flexor contractions of the trunk and limbs, pupillary dilation, elevations of blood pressure and pulse, urinary incontinence, and tongue biting. This is followed by a profound state of depressed consciousness (post-ictal state) which gradually improves over minutes to hours. The disorder may be cryptogenic, familial, or symptomatic (caused by an identified disease process). (From Adams et al., Principles of Neurology, 6th ed, p329)
Also Known As:
Epilepsy, Tonic Clonic; Major Epilepsy; Epilepsy, Tonic-Clonic; Convulsions, Grand Mal; Cryptogenic Tonic-Clonic Epilepsy; Epilepsy, Tonic-Clonic, Cryptogenic; Epilepsy, Tonic-Clonic, Familial; Epilepsy, Tonic-Clonic, Symptomatic; Familial Tonic-Clonic Epilepsy; Seizure Disorder, Grand Mal; Seizure Disorder, Major Motor; Symptomatic Tonic-Clonic Epilepsy; Tonic Clonic Convulsions; Tonic-Clonic Convulsion Disorder; Tonic-Clonic Convulsion Syndrome; Tonic-Clonic Seizure Disorder; Tonic-Clonic Seizure Syndrome; Convulsion Disorder, Tonic-Clonic; Convulsion Disorders, Tonic-Clonic; Convulsion Syndrome, Tonic-Clonic; Convulsion Syndromes, Tonic-Clonic; Convulsion, Grand Mal; Convulsion, Tonic Clonic; Convulsions, Tonic Clonic; Cryptogenic Tonic Clonic Epilepsy; Cryptogenic Tonic-Clonic Epilepsies; Disorder, Tonic-Clonic Convulsion; Disorder, Tonic-Clonic Seizure; Disorders, Tonic-Clonic Convulsion; Disorders, Tonic-Clonic Seizure; Epilepsies, Cryptogenic Tonic-Clonic; Epilepsies, Familial Tonic-Clonic; Epilepsies, Symptomatic Tonic-Clonic; Epilepsies, Tonic-Clonic; Epilepsy, Cryptogenic Tonic-Clonic; Epilepsy, Familial Tonic-Clonic; Epilepsy, Symptomatic Tonic-Clonic; Familial Tonic Clonic Epilepsy; Familial Tonic-Clonic Epilepsies; Grand Mal Convulsion; Grand Mal Convulsions; Grand Mal Epilepsy; Major Epilepsies; Seizure Disorder, Tonic-Clonic; Seizure Disorders, Tonic-Clonic; Seizure Syndrome, Tonic-Clonic; Seizure Syndromes, Tonic-Clonic; Symptomatic Tonic Clonic Epilepsy; Symptomatic Tonic-Clonic Epilepsies; Syndrome, Tonic-Clonic Convulsion; Syndrome, Tonic-Clonic Seizure; Syndromes, Tonic-Clonic Convulsion; Syndromes, Tonic-Clonic Seizure; Tonic Clonic Convulsion; Tonic Clonic Convulsion Disorder; Tonic Clonic Convulsion Syndrome; Tonic Clonic Seizure Disorder; Tonic Clonic Seizure Syndrome; Tonic-Clonic Convulsion Disorders; Tonic-Clonic Convulsion Syndromes; Tonic-Clonic Epilepsies; Tonic-Clonic Epilepsies, Cryptogenic; Tonic-Clonic Epilepsies, Familial; Tonic-Clonic Epilepsies, Symptomatic; Tonic-Clonic Epilepsy, Cryptogenic; Tonic-Clonic Epilepsy, Familial; Tonic-Clonic Epilepsy, Symptomatic; Tonic-Clonic Seizure Disorders; Tonic-Clonic Seizure Syndromes; Epilepsy, Grand Mal; Epilepsy, Major; Grand Mal Seizure Disorder; Major Motor Seizure Disorder; Seizure Disorder, Tonic Clonic
Networked: 233 relevant articles (12 outcomes, 12 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1. Seizures (Seizure)
2. Myoclonus (Nocturnal Myoclonus)
3. Epilepsy (Aura)
4. Febrile Seizures (Febrile Seizure)
5. Partial Epilepsies (Epilepsy, Partial)


1. Oda, Yutaka: 3 articles (05/2008 - 03/2004)
2. Asada, Akira: 3 articles (05/2008 - 03/2004)
3. Tanaka, Katsuaki: 3 articles (05/2008 - 03/2004)
4. Dhir, Ashish: 2 articles (12/2015 - 08/2007)
5. Umukoro, Solomon: 2 articles (09/2014 - 01/2013)
6. Mihály, A: 2 articles (09/2008 - 01/2000)
7. Takahashi, Ryota: 2 articles (05/2008 - 03/2005)
8. Funao, Tomoharu: 2 articles (03/2005 - 03/2004)
9. Kassa, J: 2 articles (09/2001 - 08/2001)
10. Chopra, Kanwaljit: 1 article (12/2015)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Tonic-Clonic Epilepsy:
1. Diazepam (Valium)FDA LinkGeneric
2. ParaldehydeIBA
3. Anticonvulsants (Antiepileptic Drugs)IBA
4. Pentylenetetrazole (Metrazol)IBA
02/28/2000 - "Generalized tonic-clonic convulsions were induced on 2 consecutive days by pentylenetetrazol (PTZ) in immature rats (postnatal days 10 and 20), and hippocampal slices were prepared at different intervals post-injection. "
05/01/2009 - "AND administered intraperitoneally exhibited dose-dependent protection against tonic-clonic convulsions caused by maximal electroshock (MES) with ED(50) (effective dose(50)) of 227 mg/kg. The compound also inhibited the convulsive action of pentylenetetrazole (PTZ), increasing its CD(50) (convulsive dose(50)) for clonic convulsions from 77.2 (PTZ + saline) to 93.9 (p < 0.05) for PTZ + AND 40 mg/kg and 113.9 mg/kg (p < 0.001) for PTZ + AND 60 mg/kg. In mice pretreated with 60 mg/kg AND, the CD(50) for PTZ-induced tonic convulsions increased from 102 to 127.6 mg/kg (p < 0.01). "
04/01/2006 - "Pentylenetetrazol (PTZ)-induced seizure in rats, a relevant model of human absence and of generalized tonic-clonic epilepsy, was used to stimulate seizure activity within 30 s of administration while collecting continuous, high-resolution, multislice images at subsecond intervals. "
02/01/1999 - "Following the transection 58% of GEPR-9s displayed a sound-induced tonic-clonic convulsion and the remaining 42% exhibited a sound-induced seizure when subjected to stimulation 5 min after a subconvulsant dose of pentylenetetrazol (PTZ). "
01/01/1988 - "Minimal seizures with a motor pattern identical to minimal metrazol seizures were observed in all the age groups and so were generalized tonic-clonic convulsions, which appeared after large doses of KA. "
5. PicrotoxinIBA
6. Phenobarbital (Luminal)FDA Link
7. Lorazepam (Ativan)FDA LinkGeneric
8. Midazolam (Versed)FDA LinkGeneric
05/01/2006 - "On admission to the hospital, 6 hours after the ingestion, she was stuporous and had 3 short, generalized tonic-clonic convulsions that were controlled with a single dose of midazolam. "
01/01/2008 - "Four trials involving 383 participants were included.(1) Intravenous lorazepam is as effective as intravenous diazepam in the treatment of acute tonic clonic convulsions, 19/27 (70%) versus 22/34 (65%), RR 1.09 (95% CI 0.77 to 1.54), has fewer adverse events and rectal lorazepam may be more effective than rectal diazepam, 6/6 versus 6/19 (31%), RR 3.17 (95% CI 1.63 to 6.14)(2) Buccal midazolam controlled seizures in 61/109 (56%) compared with 30/110 (27%) of rectal diazepam treated episodes with acute tonic-clonic convulsions, RR 2.05 ( 95% CI 1.45 to 2.91)(3) Intranasal midazolam is as effective as intravenous diazepam in the treatment of prolonged febrile convulsions, 23/26 (88%) versus 24/26 (92%), RR 0.96 (95% CI 0.8 to 1.14)(4) There is moderate evidence that intranasal lorazepam is more effective than intramuscular paraldehyde for acute tonic-clonic convulsions and patients treated with intranasal lorazepam are significantly less likely to require further anticonvulsants to control continuing seizures, 8/80 (10%) versus 21/80 (26%), RR 0.58 (95% CI 0.42 to 0.79). "
01/01/2008 - "To review the evidence comparing the efficacy and safety of midazolam, diazepam, lorazepam, phenobarbitone, phenytoin and paraldehyde in treating acute tonic-clonic convulsions and convulsive status epilepticus in children treated in hospital. "
9. topiramate (Topamax)FDA LinkGeneric
10. Valproic Acid (Valproate, Semisodium)FDA LinkGeneric

Therapies and Procedures

1. Hemispherectomy
2. Therapeutics
3. Anesthesia
4. Subcutaneous Injections
5. Injections