Presentation
GTS may present as either the initial or the primary manifestation of this syndrome (22). [neupsykey.com]
To see (anything) out, to see (it) to the end; to be present at, or attend, to the end. To see stars, to see flashes of light, like stars; sometimes the result of concussion of the head. [kmle.co.kr]
Survey and present state. Acta Radiol (Suppl) 1977; 355: 85–92. Google Scholar 5. McCormick, CC, ApSimon, HT, Chakers, RMH. Myelography with metrizamide—an analysis of the complications encountered in cervical, thoracic and lumbar myelography. [journals.sagepub.com]
A series of 6 such patients is presented. All had a history of chronic primary or post-traumatic epilepsy and presented with acute liver failure shortly after a grand mal fit. [ncbi.nlm.nih.gov]
Verbal memory items were presented during the tonic and clonic phases of both seizures. The patient correctly recalled all information presented during the first seizure (fig 2). [jnnp.bmj.com]
Entire Body System
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Epilepsy
Some GGE epilepsy syndromes (JME and juvenile absence epilepsy) have mixed GMS, and some reflect combinations (epilepsy with myoclonic absences) (16,17). [neupsykey.com]
Among children with no epilepsy waves and a normal exam, about 70% of those who have had tonic-clonic seizures will stay seizure-free without medication. The comparable number is less than 30% for children with epilepsy waves and an abnormal exam. [epilepsynewengland.org]
Besides possible ethnic factors, the relative rarity of interictal EEG abnormalities in Africans with grand mal epilepsy may be related to the larger amount of sunshine in the tropics. [ncbi.nlm.nih.gov]
epilepsy, Grand mal epilepsy, Tonic-clonic epilepsy (disorder), epilepsy; grand mal, epilepsy; major, grand mal; epilepsy, major; epileptic, Grand Mal Epilepsy, Epileptic seizures, tonic-clonic, Major epilepsy French GRAND MAL EPILEPTIQUE, Convulsions [fpnotebook.com]
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Nightmare
[…] voice or touch of others Sees, hears, feels, tastes, or smells things that no one else experiences Sweats, sudden change in heart rate, flushes, gets pale Behaviors that are rarely associated with seizures include: Sleep problems, such as sleep walking, nightmares [uichildrens.org]
Skills that make them a nightmare to bugs... And a dream to film buffs in Singapore: You can now book movie tickets on your Grab app. (Other countries coming soon!) If you update your Grab app now, it'll be the end of bugs... [apps.apple.com]
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High-Pitched Cry
Contraction of the respiratory and abdominal muscles may create a high-pitched cry or a period of hypopnea. Seizure intensities may vary among patients and individuals, and combined seizure types may also occur (29). [neupsykey.com]
Respiratoric
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Loud Snoring
After these series of contractions, there is an extended postical state where the person is unresponsive and commonly sleeping with loud snoring. [en.wikipedia.org]
Gastrointestinal
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Fecal Incontinence
Muscular flaccidity resulting in urinary or fecal incontinence. Total amnesia of the seizure. Emergency Management Should a patient exhibit a grand mal seizure, the following steps should be taken: PRODROMAL AND PREICTAL PHASE Recognize aura. [dentalcare.com]
Neurologic
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Seizure
Despite its accepted safety, its use has been associated with generalized motor seizures, and several cases of this toxicity have been reported. Risk factors include phenothiazine ingestion, seizure history, and large doses of the contrast material. [ncbi.nlm.nih.gov]
GGE with sporadic GTC seizures may be self-limiting and express a single seizure semiology (5,16). Other syndromes with GTC seizures persist throughout life (epilepsy with GTC seizures on awakening). [neupsykey.com]
Others who are seizure-free for a year or two while taking seizure medicine may stay seizure-free if the medicine is gradually stopped. [epilepsynewengland.org]
There are several different types of seizures, including grand mal seizures. Grand mal seizures, also known as generalized tonic-clonic seizures, include a loss of consciousness and violent muscle contractions. [centerforneuroandspine.com]
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Aura
A patient with a history of seizures may recognize the development of an “aura” consisting of olfactory, visual, gustatory or auditory changes. [dentalcare.com]
Q: What is an aura? A: Before the onset of a seizure some people experience a sensation or warning called an “aura.” An aura may occur far enough in advance to give the person time to avoid possible injury. [epilepsy-ohio.org]
Ecstatic feelings Headache Increased agitation Insomnia Irritability Lightheadedness Mood changes AURAS Auras are actually a small partial seizure that is often followed by a larger event. [epilepsytalk.com]
Symptoms of a Tonic-Clonic (Grand Mal) Seizure Aura The seizure may start with a simple or complex partial seizure known as an aura. The person may experience abnormal sensations such as a particular smell, vertigo, nausea, or anxiety. [hopkinsmedicine.org]
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Stroke
In addition to administering 100% oxygen, it is important to: A. use the Cincinnati Stroke Scale to rule out a stroke. B. start an IV line with a hypertonic crystalloid solution. C. assess his blood glucose level to rule out hypoglycemia. [brainscape.com]
But sometimes, this type of seizure can be triggered by other health problems, such as extremely low blood sugar, a high fever or a stroke. Many people who have a grand mal seizure never have another one and don't need treatment. [mayoclinic.org]
National Institute of Neurological Disorders and Stroke: "Seizures and Epilepsy: Hope Through Research." [webmd.com]
Seizures can be caused by strokes, tumors, medications, fevers, infections or withdrawal. They are most often, however, associated with epilepsy. [franciscanhealth.org]
Though the exact cause of grand mal seizures is unknown, grand mal seizures can be caused by: Traumatic head injuries Stroke Blood vessel malformations in the brain Genetic disorders Tumors Very low blood levels of glucose, sodium, calcium or magnesium [centerforneuroandspine.com]
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Generalized Tonic-Clonic Seizure
[…] with grand mal on awakening, idiopathic generalized epilepsy of adolescence and young adulthood with generalized tonic-clonic seizures, and genetic epilepsy with generalized tonic-clonic seizures alone. [medlink.com]
Generalized tonic-clonic seizure is a type of seizure that involves the entire body. It is also called grand mal seizure. The terms seizure, convulsion, or epilepsy are most often associated with generalized tonic-clonic seizures. [medlineplus.gov]
A number of medications are used for the treatment of generalized tonic-clonic seizures. [emedicine.medscape.com]
Generalized tonic-clonic seizures (also called grand mal seizures) Generalized tonic-clonic seizures are characterized by five distinct phases that occur in the child. [chp.edu]
External links [ edit ] Generalized tonic–clonic seizure at Curlie [en.wikipedia.org]
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Amnesia
Total amnesia of the seizure. Emergency Management Should a patient exhibit a grand mal seizure, the following steps should be taken: PRODROMAL AND PREICTAL PHASE Recognize aura. [dentalcare.com]
[…] urine or stool control (incontinence) Stopped breathing or difficulty breathing Blue skin color After the seizure, the person may have: Confusion Drowsiness or sleepiness that lasts for 1 hour or longer (called the post-ictal state) Loss of memory (amnesia [medlineplus.gov]
Jerking of the arms or legs Loss of bladder or bowel control Limited or even stopped breathing Blue lips Arched back After the seizure the patient may experience: Confusion Feeling sleepy or drowsy for 1 hour or longer (post-ictal state) Loss of memory (amnesia [cedars-sinai.edu]
fumbling, lip smacking, chewing, swallowing) Confusion Anterograde amnesia Aphasia Fatigue, possibly short phase of coma Muscular flaccidity and muscle pain Headache Focal seizures may evolve to generalized convulsive seizure (formerly secondarily [amboss.com]
Workup
The awake EEG of patients with generalized tonic-clonic seizure may be normal; however, certain specific interictal EEG patterns can be distinctive of generalized epilepsy syndromes (see Workup). [emedicine.medscape.com]
EEG
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Generalized Epileptiform Discharges
epileptiform discharge (ED) (11,18). [neupsykey.com]
Although not always available, an EEG would show generalized epileptiform discharges during the event. An absence seizure is by definition a seizure of generalized onset. [onlinelibrary.wiley.com]
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Rhythmic Slowing
As the seizure progresses to the clonic phase, the fast rhythm is fragmented by rhythmic slow waves. [scielo.br]
During the clonic phase, the initial fast rhythm becomes fragmented by rhythmic slow waves. Intermittent polyspikes are apparent and accompany the clonic jerk with a decreasing slow-wave frequency during the relaxation period (5,10). [neupsykey.com]
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Multifocal Independent Spikes
(A) Slow spike-and-waves and (B) multifocal independent spike discharges in two patients with GMS and mixed tonic, tonic–clonic, and myoclonic seizures. (From Tatum WO. Handbook of EEG Interpretation. 2nd ed. [neupsykey.com]
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Multifocal Spikes
In most patients with GTS associated with EGE, a diffusely slow background with multifocal spikes and sharp waves (Figure 14.7b) is present on the EEG reflecting a diffuse structural injury of the brain (22). [neupsykey.com]
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Burst Suppression
benign myoclonic epilepsy of infancy) from more malignant epilepsies associated with GMCS and burst suppression (early myoclonic encephalopathy). [neupsykey.com]
Treatment
Abstract In a controlled clinical investigation based on 14 patients with focal seizures and 3 patients with secondary generalized grand mal epilepsy, all with insufficient response to conventional anti-epileptic treatment, clonazepam (Rivotril(R)) combined [ncbi.nlm.nih.gov]
Tonic-clonic: First‑line treatment: lamotrigine, valproate, phenobarbital (children) Second-line treatment: carbamazepine, zonisamide Typical absence: First‑line treatment: ethosuximide, valproate Second‑line treatment: lamotrigine, clonazepam Atypical [amboss.com]
Some physicians would not start treatment until second or repeated seizures occur. Treatment is usually based on an individual’s symptoms and the accompanying diagnosis. [startstemcells.com]
Treatments Correct treatment can help reduce or prevent seizures. In some cases, treatment can help patients to remain free of seizures for the rest of their lives. [cedars-sinai.edu]
However, if SE is suspected, then prompt treatment is necessary to minimize morbidity and mortality. [jems.com]
Prognosis
The neurological prognosis and overall survival of these patients remains poor. [ncbi.nlm.nih.gov]
thiopental, propofol, or midazolam Nonbenzodiazepine therapy (to prevent recurrence): fosphenytoin or valproate Prognosis Status epilepticus is a life‑threatening event! [amboss.com]
Combinations of GMS semiologies and EEG may permit identification of a specific epilepsy syndrome that influences treatment and ultimately prognosis (early myoclonic encephalopathy). [neupsykey.com]
Seite 260 - Clinical course and prognosis of temporal lobe epilepsy: a survey of 666 patients. Seite 11 - EEG changes indicate initial activation of a system of neurons limited to part of one cerebral hemisphere. [books.google.de]
Prognosis is markedly variable, from excellent in mild cases to severe with continuing GTCS becoming more frequent and less dependent on sleep-waking cycle and precipitating factors. [medlink.com]
Etiology
Unknown Immune Infectious Structural Etiology Metabolic Genetic Epilepsy types Focal Generalized Combined Generalized & Focal UnknownFocal Epilepsy Syndromes Seizure types Generalized onset Unknown onset Focal onset 30. [slideshare.net]
Etiology Epilepsy Although these seizures are referred to as unprovoked, they may be triggered by certain provocative factors! [amboss.com]
GMS may be observed in several different epilepsy syndromes and are associated with various etiologies, including a structural–metabolic (symptomatic), genetic (idiopathic), or unknown (cryptogenic) cause (5). [neupsykey.com]
SLE) Infectious etiologies:. .. .. Abscess. .. .. Encephalitis, meningitis. .. .. Rasmussen's syndrome (presumed viral) Tumors and Congential etiologies:. .. .. Heterotopias (refer to the chapter on developmental brain anomalies). .. .. [hawaii.edu]
An idiopathic seizure is a seizure: A. without an identifiable etiology. B. resulting from alcohol withdrawal. C. caused by an intracranial pathology. D. caused by subtherapeutic drug levels. A. without an identifiable etiology. [brainscape.com]
Epidemiology
Epiomic Epidemiology Series: Mucopolysaccharidosis Type I Forecast in 27 Major Markets 2018-2028 리서치사 Black Swan Analysis 발행일 2018년 05월 상품 코드 636640 페이지 정보 영문 74 Pages 가격 US 5,800 7,035,000 PDF by E-mail (Single User License) US 8,700 10,553,000 PDF by [giikorea.co.kr]
Definition References:[1][2][3][4][5] Epidemiology References:[6] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]
We also acknowledge the additional statistical assistance received from John Carlin, PhD, Clinical Epidemiology & Biostatistics Unit, Royal Children's Hospital, Melbourne, Victoria, Australia. 1. [jamanetwork.com]
Epidemiology The age-adjusted incidence of epilepsy (ie, recurrent unprovoked seizures) ranges from 24-53 per 100,000 population per year. Approximately 20-25% of cases are classified as generalized seizures. [emedicine.medscape.com]
Pathophysiology
[…] of Secondarily Generalized Seizures View Table Favorite Table Download (.pdf) Table 11-1 Classification of Secondarily Generalized Seizures Type of Seizure Description Tonic-clonic seizures Probably consist of multiple types and may involve different pathophysiologic [neurology.mhmedical.com]
Pathophysiology Generalized epilepsy is thought to be initiated by 3 different mechanisms: Abnormal response of hyperexcitable cortex to initially normal thalamic input Primary subcortical trigger Abnormal cortical innervation from subcortical structures [emedicine.medscape.com]
In this updated article, the author details the clinical manifestations, pathophysiology, EEG, and neuroimaging of generalized onset tonic-clonic seizures and provides clues for correct diagnosis and optimal management of patients. [medlink.com]
International classification of seizure types (1981)[edit] This classification is based on observation (clinical and EEG) rather than the underlying pathophysiology or anatomy. [en.wikipedia.org]
Despite the apparent homogeneous classification of seizure semiology, various underlying pathophysiologic mechanisms occur. GTS typically occurs with varying degrees of cognitive dysfunction and mental retardation. [neupsykey.com]
Prevention
Position the patient in a supine position with the feet elevated or roll patient on their side to prevent aspiration. Protect the patient from bodily injury, however do not place objects in the mouth to prevent soft tissue injury. [dentalcare.com]
Magnesium and CBD Hemp Oil: Both of these work astonishingly well for preventing and treating seizures. [life-saving-naturalcures-and-naturalremedies.com]
Contrary to folk wisdom, it is a bad idea to stick something in the patient's mouth to prevent him or her from swallowing his or her tongue. It may do more harm than good, and people can bite but can't swallow their own tongues. [franciscanhealth.org]
This is prevented by inserting something into the patient’s mouth. However, this hurts the patient the more tightly the jaw is closed. [startstemcells.com]