A hoarse cry or sound during a tonic-clonic seizure may occur as the vocal cords contract and air is forcefully expelled from the lungs, producing a loud moan or cry often called an "ictal cry." This is typically seen in the tonic phase of the seizure, when muscle stiffness causes the person to fall and there may be vocalizations like groaning or yelling. The hoarse cry is due to air pushing past the voice box during this phase. Thus, a hoarse cry can indeed be a sign that a person is having a tonic-clonic seizure, reflecting the impaired breathing and muscle contractions happening at that time.