Presentation
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]
Presentation A severe asthma attack is one that comes on very quickly and worsens very quickly. [nature.com]
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
- 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]
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]
The muscles will stiffen (tonic phase), causing him/her to fall to the floor. Increased pressure on the bladder and bowel may cause wetting (urinary incontinence) or soiling (fecal incontinence). [epilepsyontario.org]
- 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]
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]
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]
- 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]
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]
Respiratoric
- 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]
Face, Head & Neck
- Episodic Headache
Headache Weakness of 1 side of the body for a few minutes to a few hours following seizure (called Todd paralysis) The doctor will perform a physical exam. [nlm.nih.gov]
They can occur once (single episode). Or, they can occur as part of a repeated, chronic illness (epilepsy). Some seizures are due to psychological problems (psychogenic). [account.allinahealth.org]
Headache Weakness of one side of the body for a few minutes to a few hours (Todd paralysis) Causes and Risk Factors These seizures are usually caused by epilepsy. [cedars-sinai.edu]
Headache Weakness of one side of the body for a few minutes to a few hours following seizure (called Todd paralysis) Exams and Tests The doctor will perform a physical exam. [indiatoday.in]
Neurologic
- 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]
- 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]
Phase 5 consists of sustained contraction of all voluntary musculature in the tonic posture with minimal clonic jerking. [annalsofian.org]
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
- 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
Generalized spike-and-wave often becomes fragmented with sleep deprivation or in sleep. Fragmented generalized spike-and-wave can appear focal or multi-focal but usually is not consistently seen in 1 area. [medlink.com]
Treatment
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]
Prognosis
Abstract Clinical course and long-term seizure prognosis were studied in 155 patients with complex-partial seizures during a follow-up of 10.1 +/- 1 (SD) years. [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]
Etiology
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]
Introduction Definition a seizure presentation characterized by body stiffening (tonic) and rhythmic jerking (clonic) movements Etiology can begin as a partial seizure that secondarily generalizes bilateral hemispheric seizures Presentation Symptoms/physical [medbullets.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]
Epidemiology
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]
Epidemiological studies can be useful to eradicate these infections and to provide further measures of hygiene and education. 1. [hindawi.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.com]
Pathophysiology
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]
Prevention
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]
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]
Determining the risk factors associated with increased DMSO toxicity and taking preventive actions is utmost important. [ncbi.nlm.nih.gov]