Which statement best describes the order of stages in a grand mal seizure?

• A. Aura → Tonic → Clonic → Recovery → Status epilepticus
• B. Aura → Clonic → Tonic → Recovery → Status epilepticus
• C. Tonic → Aura → Clonic → Recovery → Status epilepticus
• D. Aura → Tonic → Recovery → Clonic → Status epilepticus

Answer: (B)

In a grand mal (generalized tonic–clonic) seizure, there is a recognizable progression starting with a warning sensation called an aura (if one is present), then a phase of convulsive activity that moves through distinct motor patterns, followed by a period of recovery as consciousness returns. The important ideas to hold onto are: aura may precede the event, there is a convulsive phase, and after the seizure ends the person goes into a postictal recovery where they may be confused or drowsy. If the seizure lasts too long or seizures recur without full recovery in between, this can develop into status epilepticus, a medical emergency.

So the sequence begins with the aura, then the body exhibits convulsive activity, then the person gradually recovers, and if the seizure is prolonged, it may become status epilepticus.