Tonic-clonic seizures may be Generalized-onset (formerly primarily generalized) Focal-to-bilateral tonic-clonic (formerly, secondarily generalized) Generalized-onset tonic-clonic seizures typically begin with an outcry; they continue with loss of consciousness and falling, followed by tonic contraction, then clonic (rapidly alternating contraction and relaxation) motion of muscles of the extremities, trunk, and head.