Children with catatonic epilepsy usually present with petit mal seizures, and grand mal seizures may occur when combined with other types of epilepsy. Grand mal seizure, also known as generalized tonic clonic seizure, is a type of generalized seizure in epilepsy, with early loss of consciousness and fall, followed by three phases, namely tonic phase (manifested as persistent contraction of skeletal muscles all over the body), clonic phase (manifested as alternating contraction and relaxation of the muscles), and late phase of the seizure (which may be manifested by clenching of teeth and incontinence of urine, followed by gradual recovery). Aphasic epilepsy, i.e. epileptic catatonic seizure, is a type of generalized seizure, mostly petit mal seizure, which typically manifests itself as a sudden and brief loss of consciousness and interruption of movement, with no response to call, followed by immediate wakefulness and no memory of waking up. It can also be characterized by typical seizures without loss of consciousness and accompanied by decreased muscle tone, occasionally accompanied by myoclonus. Grand mal seizures may occur when accompanied by other types of epilepsy. Childhood absence epilepsy usually begins in childhood, is rarely accompanied by myoclonus, and usually stops before puberty. A few children may develop generalized tonic clonic seizures during adolescence, which should be treated aggressively.