First aid for tonic and atonic seizures


In part two of our first aid for seizures blog series, our Helpline & Information Officer, Stuart Macgee looks at first aid for tonic and atonic seizures.

Both atonic and tonic seizures can result in falls and other injuries. In an atonic seizure, there is a loss of muscle tone and the person’s body goes floppy and the person usually drops to the ground.

In a tonic seizure, the person may become suddenly stiff and usually fall backwards.

Since there is usually no warning and it occurs quickly, there is often no time to protect the person from hurting themselves.

With both these types of seizures there is a high risk of injury to the face and head, because of the way the person falls. Recovery from these types of seizures is usually quick.


What to do

Sometimes a person may have other seizures before a tonic or atonic seizure that may warn them to sit or lie down. For example, absence or myoclonic seizures may be seen in people with tonic or atonic seizures and often occur in clusters.

People who have frequent atonic or tonic seizures without warning may need protective headgear or helmet. If they fall forward and injure the face frequently, a face mask or helmet to prevent injury should be considered. More information can be found in our staying safe with epilepsy guide.

When someone has a tonic or atonic seizure you should:

  • check the person has not been hurt
  • if they are hurt and need medical treatment phone an ambulance
  • be reassuring after the seizure
  • stay until the person has fully recovered

atonic and tonic seizures


After an atonic seizure

After an atonic seizure, the person may or may not be confused.

Often a person can return to their usual activity fairly quickly. Some may need to rest for a while after a seizure.

If the person fell, they may have been injured and need first aid for bruises, cuts, or other injuries.

For serious injuries (like a broken bone or head injury), the person will need to go to an A&E.


After a tonic seizure

When a tonic seizure ends, the person may or may not be sleepy or confused. Typically, no first aid is needed unless a person is not fully aware during or after the seizure.

Preventing injury is a key part of first aid for tonic seizures. Some people may need to wear protective equipment like a helmet to prevent head injuries from falls.

In part three of our first aid for seizures blog series we will be looking at first aid for focal aware seizures also known as simple partial seizures and focal seizures with impaired awareness otherwise known as complex partial seizures.

For more information, please check out our first aid for seizures factsheet by clicking here.