We present a 68-year old female with an epidermoid cyst with intracystic hemorrhage who presented with a first time generalized tonic clonic seizure. [ncbi.nlm.nih.gov]

• Falling

  A person undergoing a convulsion loses consciousness and falls to the ground. The fall is sometimes preceded by a shrill scream caused by forcible expiration of air as the respiratory and laryngeal muscles suddenly contract. [britannica.com]

  You might be at risk of: Falling. If you fall during a seizure, you can injure your head or break a bone. Drowning. If you have a seizure while swimming or bathing, you're at risk of accidental drowning. Car accidents. [mayoclinic.org]

  He is bagging groceries when the cashier suddenly stiffens up and falls to the floor. Once on the floor, his arms and legs are jerking and bending quickly and repeatedly. [study.com]

  […] which may be tactile, visual, auditory, or musical. gen·er·al·ized ton·ic-clo·nic sei·zure a generalized seizure characterized by the sudden onset of tonic contraction of the muscles often associated with a cry or moan, and frequently resulting in a fall [medical-dictionary.thefreedictionary.com]

• Fatigue

  Sleep deprivation, fatigue and alcohol lower threshold for seizures. Antecedent and birth history is normal, although there are patients with a previous history of childhood absence epilepsy. Neurological examination and head size is normal. [epilepsydiagnosis.org]

  During the postictal period, the child may be sleepy, have problems with vision or speech, and may have a bad headache, fatigue, or body aches. Tonic seizures Tonic seizures usually last less than 20 seconds. [chp.edu]

  After a seizure, the person may feel fatigue, confusion and disorientation, which may last from five minutes to several hours or even days. Rarely, this disorientation may last up to two weeks. [epilepsyontario.org]

  These include: Blood clots Blood loss Heart attack Stroke Reaction to medication Additionally, there are side effects that may occur after the surgical procedures, including: Scalp numbness Fatigue Depression Headaches Difficulty speaking Loss of memory [northwell.edu]

  Fatigue. Sleepiness is common after a grand mal seizure. Severe headache. Headaches may occur after a grand mal seizure. [mayoclinic.org]

• Unconsciousness

  The tonic phase of the seizure gradually gives way to clonic convulsive movements occurring bilaterally and synchronously before slowing and eventually stopping, followed by a variable period of unconsciousness and gradual recovery. [medical-dictionary.thefreedictionary.com]

  At the start of the seizure: the person becomes unconscious their body goes stiff and if they are standing up they usually fall backwards they may cry out they may bite their tongue or cheek. [epilepsysociety.org.uk]

  Your doctor will likely need to speak to a witness who has seen your seizures, as people tend to go unconscious during grand mal seizures. The doctor will also perform a neurological exam. [cedars-sinai.edu]

  Unconsciousness may persist for several minutes after the convulsion has ended. Confusion. A period of disorientation often follows a grand mal seizure. This is referred to as postictal confusion. Fatigue. [mayoclinic.org]

  Use back blows and chest thrusts in babies less than one year of age Unconsciousness: if the patient becomes unconscious, phone 999 or 112 and start CPR. [nature.com]

• Sighing

  Usually a deep sigh signals the end of the jerking and normal breathing resumes. The seizure is now over but the child is not awake and will not respond immediately. [doosesyndrome.org]

  The person may let out a deep sigh and return to more normal breathing. After the Seizure (Postictal Period) After a seizure, the person may remain unconscious for several minutes as the brain recovers from the seizure activity. [hopkinsmedicine.org]

• Loud Snoring

  After these series of contractions, there is an extended postictal state where the person is unresponsive and commonly sleeping with loud snoring. [en.wikipedia.org]

• Clonus

  See epilepsy. atonic seizure an absence seizure characterized by sudden loss of muscle tone. focal motor seizure a simple partial seizure consisting of clonus or spasm of a muscle or muscle group, occurring either singly or in a continuous repetitive [medical-dictionary.thefreedictionary.com]

  […] specificity in describing the onset of a seizure and being considered an archaic term, it is not typically used by medical professionals. [3] See also [ edit ] Focal seizure Absence seizure Epileptic seizure Non-epileptic seizure Tonic (physiology) Clonus [en.wikipedia.org]

  Pirminiai generalizuoti toniniai-kloniniai priepuoliai English Primary Generalised Tonic-Clonic Seizures Last Update: 2017-04-26 Usage Frequency: 1 Quality: Reference: IATE Lithuanian traukuliai, kloniniai traukuliai, smegenų edema English Convulsion, clonus [mymemory.translated.net]

• Neglect

  "The Postictal State: A Neglected Entity in the Management of Epilepsy". Epilepsy & Behavior. 1 (1): 52–59. doi : 10.1006/ebeh.2000.0023. ISSN 1525-5050. "Triggers of Seizures". Epilepsy Foundation. Retrieved 2018-12-07. [en.wikipedia.org]

• Tremulousness

  We divided GTCSs into the following phases: onset of generalization, pretonic clonic, tonic, tremulousness, and clonic. The mean GTCS duration was 62 seconds. [ncbi.nlm.nih.gov]

• Tonic Posturing

  Clonic jerking started in the left arm that then assumed a tonic posture with the arm forcibly flexed and abducted, with superimposed clonic movements. [jnnp.bmj.com]

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]

• Photoparoxysmal Response

  Before seizure onset, IPS consistently induced generalized photoparoxysmal responses (PPRs). [ncbi.nlm.nih.gov]

  An intermittent photoparoxysmal response to photic stimulation may be seen. EEG abnormality is enhanced by sleep deprivation and in sleep. Generalized spike-and-wave often becomes fragmented with sleep deprivation or in sleep. [medlink.com]

• Focal Spikes

  The morphology of the focal spike-and-wave typically appears similar to the generalized spike-and-wave. Ictal. With generalized convulsive seizures, the ictal EEG is often obscured by artifact. [medlink.com]

Fifty-two (24%) of the 215 patients randomized to immediate treatment and 85 (42%) of the 204 randomized to delayed treatment experienced seizure recurrence during follow-up. [ncbi.nlm.nih.gov]

Abstract The prognosis for seizure recurrence was assessed in 133 patients who presented at a median of 1 day after a first-ever tonic-clonic seizure. [ncbi.nlm.nih.gov]

For further reference to treatment onset and epilepsy prognosis, see Progress in Pediatric Neurology II, PNB Publ, 1994:pp92-93. [pediatricneurologybriefs.com]

Age, acute treatment of the seizure with benzodiazepines, remote etiologic factors, and EEG abnormalities were significant predictors of relapse. [ncbi.nlm.nih.gov]

[…] repeated, chronic condition–epilepsy, and are caused by abnormal electrical activity at multiple locations in the brain, or over most of the brain, which may be accompanied by changes in mental status–alertness, awareness and/or focal neurologic Sx Etiology [medical-dictionary.thefreedictionary.com]

Etiology Most generalized epilepsies are idiopathic. However, a definite genetic locus has been found for some of these generalized types of epilepsy. [emedicine.com]

This article aims to provide a brief overview of the epidemiology, etiology, investigation and treatment of a first generalized tonic-clonic seizure. [ncbi.nlm.nih.gov]

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.com]

1 Epidemiology and Outcome of Idiopathic Generalized Epilepsy in Adults. 61 31838768 2019 2 Early necrotic skin lesions after a ABO-incompatible kidney transplantation: The threat of Cunninghamella Spp. 61 Belliere J...Kamar N 31529558 2019 3 Sleepwalking [malacards.org]

The condition is rare and the exact pathophysiology is unknown. [ncbi.nlm.nih.gov]

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.com]

Treatment and Prevention Tonic-clonic seizure treatment is primarily focused on prevention, however, in some situations such as with prolonged seizures, treatment will be needed acutely. [verywellhealth.com]

Do - prevent crowds gathering round. Do - place a cushion or some clothing under the person's head to prevent injury. Do not - try to restrain the person. [patient.info]

Determining the risk factors associated with increased DMSO toxicity and taking preventive actions is utmost important. [ncbi.nlm.nih.gov]

Management [ edit ] For a person experiencing a tonic–clonic seizure, first-aid treatment includes rolling the person over into the recovery position, which can prevent asphyxiation by preventing fluid from entering the lungs. [12] Other general actions [en.wikipedia.org]