 Long-term therapy may include the use of antiepileptic drugs, surgical therapy, diet therapy (ketogenic diet), vagus nerve stimulation, or radio surgery.Generalized tonic–clonic seizures can have a focal onset (described above) that progresses into a generalized seizure or be a generalized seizure at onset.The term "Grand Mal" is nonspecific; referring to generalized tonic–clonic seizures with either a focal or generalized onset.