During this type of seizure activity, the patient loses consciousness suddenly, sometimes with a cry, and the body stiffens into tonic extensor rigidity. Breathing stops, and the person becomes cyanotic. A clonic phase of rhythmic muscular contraction follows. This type of seizure activity is referred to as the:

During this type of seizure activity, the patient loses consciousness suddenly, sometimes with a cry, and the body stiffens into tonic extensor rigidity. Breathing stops, and the person becomes cyanotic. A clonic phase of rhythmic muscular contraction follows. This type of seizure activity is referred to as the:

• A. focal seizure with impairment of consciousness
• B. Jacksonian seizure
• C. focal seizure that becomes generalized
• D. grand mal seizure

Answer: (D)

This describes a generalized tonic-clonic seizure. The pattern of abrupt loss of consciousness with immediate stiffening of the body (tonic phase), possible apnea and cyanosis, followed by rhythmic body jerking (clonic phase) is the classic sequence of a generalized onset seizure. It’s the type historically called a grand mal seizure, though today we usually refer to it as a generalized tonic-clonic seizure. Understanding why this is the best fit: the key feature is bilateral involvement right from the start, with a tonic phase that disrupts breathing and causes cyanosis, rather than a seizure that begins in one area of the brain and then spreads. A focal seizure with impairment of consciousness would start with focal symptoms and impaired awareness, not immediate whole-body tonic stiffening. A Jacksonian seizure describes a focal motor seizure that begins in a localized region (often a limb) and may march to other areas. A focal seizure that becomes generalized would start focal and then secondarily generalize, but the onset would not be the abrupt bilateral tonic stiffening described here.

This describes a generalized tonic-clonic seizure. The pattern of abrupt loss of consciousness with immediate stiffening of the body (tonic phase), possible apnea and cyanosis, followed by rhythmic body jerking (clonic phase) is the classic sequence of a generalized onset seizure. It’s the type historically called a grand mal seizure, though today we usually refer to it as a generalized tonic-clonic seizure.

Understanding why this is the best fit: the key feature is bilateral involvement right from the start, with a tonic phase that disrupts breathing and causes cyanosis, rather than a seizure that begins in one area of the brain and then spreads. A focal seizure with impairment of consciousness would start with focal symptoms and impaired awareness, not immediate whole-body tonic stiffening. A Jacksonian seizure describes a focal motor seizure that begins in a localized region (often a limb) and may march to other areas. A focal seizure that becomes generalized would start focal and then secondarily generalize, but the onset would not be the abrupt bilateral tonic stiffening described here.