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]
[…] 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]
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]
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]
[…] to the ground.— Jen Waters, The Washington Times, 4 July 2006 Most often, though, they [seizures] fall in a well-documented spectrum of mental and somatic anomalies, from the transient episodes of decreased awareness known as absence (formerly called [merriam-webster.com]
- Crying
[…] seizure in response to a sensory stimulus, 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 [medical-dictionary.thefreedictionary.com]
The person will usually emit a short, loud cry as the muscles in the chest contract and the air rushes between the vocal cods, making a sound. This cry does not indicate pain. [epilepsyontario.org]
The may bite their tongue, and they may cry or groan. This is the tonic phase of the seizure. The second stage is the clonic phase. During this phase, the arms and legs begin to jerk rapidly. They will bend and relax repeatedly. [study.com]
They may let out a cry as air is pushed out of their lungs but they are not in any pain. Consciousness is lost and they will usually fall to the floor if standing, often backwards. Breathing may become laboured or stop momentarily. [youngepilepsy.org.uk]
Sometimes the person may cry out as the vocal cords contract and air is released from the lungs. The person may turn blue because he or she isn't breathing. This is the tonic phase of the seizure. [cigna.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]
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]
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]
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]
- 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]
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]
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]
- Weight Gain
gain; vertigo (sense of spinning); problems walking normally; problems with muscle coordination; headache; bruising; abdominal pain; anxiety FYCOMPA is a controlled substance (CIII) because it can be abused or lead to drug dependence. [fycompa.com]
gain, such as self-induced vomiting (H+ and K+ loss), misuse of laxatives or diuretics (HCO3- and K+ loss). [intensivecarenetwork.com]
Weight gain was also reported with sodium valproate and gingival hypertrophy / hyperplasia was reported on phenytoin. [cochrane.org]
Overall, valproate is accepted as the first-line AED for the IGEs, [58],[63] and the main concerns with its use are teratogenesis in women of reproductive age and weight gain. [annalsofian.org]
Skin
- Dermatitis
[…] rubber, and chromate tanning agents used in leather footwear), irritant contact dermatitis, and psoriasis. [merckmanuals.com]
(2-13 years old) with presumed foot dermatitis; 8 of those patients were found to have dermatophyte infections, identified with KOH preparations. [jamanetwork.com]
The differential diagnosis of tinea pedis includes: Foot eczema — especially pompholyx (pedopompholyx), or irritant contact dermatitis due to persistent moisture between closely adherent toes Contact allergic dermatitis to a component of footwear (such [dermnetnz.org]
It is most commonly seen in children who are atopic, particularly boys aged four to eight years.6 Contact dermatitis – sweat, friction and home-remedies can cause irritant contact dermatitis; contact allergy may be due to accelerants (from rubber), chrome [bpac.org.nz]
Tea tree oil can cause contact dermatitis in some people. Find therapeutic-grade tea tree oil on Amazon. Athlete’s foot can lead to complications in some cases. [healthline.com]
- Skin Lesion
Or, a doctor may order a skin test if they aren’t sure a fungal infection is causing your symptoms. A skin lesion potassium hydroxide exam is the most common test for athlete’s foot. [healthline.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]
These lesions are especially common between the toes but may involve the entire sole. Because of the numerous breaks in the skin, lesions commonly become infected with bacteria. [skinsight.com]
Psychiatrical
- Suggestibility
It also suggests that seizure should be considered an adverse event related to taser use. [ncbi.nlm.nih.gov]
A review of the table suggests a mechanism for these unusual seizures. In all patients, the seizure focus was extratemporal. [jnnp.bmj.com]
Russell’s sign, namely calluses on the knuckles or back of the hand may support the suggestion of repeated self-induced emesis. [intensivecarenetwork.com]
- Visual Hallucination
hallucinations (objects or things are seen that aren’t really there) Numbness, tingling, or electric shock like feeling in body, arm or leg Out of body sensations Feeling detached Déjà vu or jamais vu Body parts feels or looks different Feeling of panic [epilepsy.com]
For instance, simple visual hallucinations (flashing lights or dots) in one visual field suggest involvement of the contralateral primary visual cortex. [annalsofian.org]
- Aggressive Behavior
Before taking FYCOMPA, tell your healthcare provider about all of your medical conditions, including if you: have or have had depression, mood problems, aggressive or hostile behavior (for example, homicidal behavior), suicidal thoughts or behavior, or [fycompa.com]
Neurologic
- Tingling
“Strange” feelings Fear/panic (often negative or scary feelings) Pleasant feelings Racing thoughts Physical Changes : Dizzy or lightheaded Headache Nausea or other stomach feelings (often a rising feeling from the stomach to the throat) Numbness or tingling [epilepsy.com]
This could be anything from a tingling sensation to seeing lights. The patient may scream, and they could lose control of their bladder and/or bowels during the seizure, or right after. [rscdiagnosticservices.com]
A tingling or warmth down one side of the body is typical. Because the parietal lobe is closely associated with the frontal lobe, people sometimes experience movement too. [web.archive.org]
[…] partial seizure can cause: a general strange feeling that's hard to describe a "rising" feeling in your tummy – like the sensation in your stomach when on a fairground ride a feeling that events have happened before (déjà vu) unusual smells or tastes tingling [nhs.uk]
- Ataxia
[…] tonic-clonic (PGTC) seizures in different syndromes (juvenile myoclonic epilepsy, juvenile absence epilepsy, childhood absence epilepsy, or epilepsy with Grand Mal seizures on awakening lt Jei pirmininko nėra, jo pareigas atlieka pirmininko pavaduotojas en ataxia [lt.glosbe.com]
[…] article is typical of what is called a grand mal seizure. et Semu, see oli...Mul on kahju en treatment), convulsions (grand mal convulsion), abnormal (unstable) gait, increased pressure in the head (intracranial hypertension), lack of coordination (ataxia [et.glosbe.com]
«Epilepsy Research UK, जुलाई 15» First de novo KCND3 mutation causes severe Kv4.3 channel … ... encephalopathy syndromes [19], KCNA1 in episodic ataxia type 1 [20], KCNC3 in SCA13 [21] and recently myoclonic epilepsy and ataxia in KCNA2[22]. [educalingo.com]
Common side effects of Klonopin include: drowsiness.Other side effects include: upper respiratory tract infection, ataxia, depression, and dizziness. [najdi.si]
It may present as neuromuscular disease with neuropathy and myositis, there can be epileptic attacks with cerebral calcifications or progressive encephalopathy with ataxia and epilepsy. [medvik.cz]
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]
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]
In addition to the causative dermatophytes and yeasts, NDMs have been described as etiological agents of foot mycoses. [hindawi.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]
But someone who has recurrent seizures may need treatment with daily anti-seizure medications to control and prevent future grand mal seizures. Symptoms Grand mal seizures have two stages: Tonic phase. [mayoclinic.org]
What can I do to help my child prevent a tonic-clonic seizure? You may not be able to prevent every seizure. [drugs.com]