Stakeholder ( Chief Editor Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida Morsani College of Medicine Selim R Benbadis, MD is a [medscape.com]

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in people with chronic uncontrolled epilepsy (Tomson et al., 2008 ). [onlinelibrary.wiley.com]

For some people living with epilepsy, the risk of Sudden Unexpected Death in Epilepsy (SUDEP) is an important concern. [cdc.gov]

What is epilepsy How is epilepsy diagnosed? Types of seizures Seizure Triggers Epilepsy is a disorder of brain function that takes the form of recurring convulsive or non-convulsive seizures. [epilepsyaustralia.net]

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]

Generally, seizures fall into the two categories: focal and generalized seizures. The difference between these types is how they begin. [epilepsyqueensland.com.au]

If they are standing they often fall, usually backwards, and may injure the back of their head. Tonic seizures tend to be very brief and happen without warning. [epilepsysociety.org.uk]

TONIC-CLONIC – ( grand mal) convulsive (Most often recognized, but only 10% of those with epilepsy have this type of seizure) Stiffens, may utter cry, loss of consciousness, falls, body jerking 1 – 3 minutes loss of bladder or bowel control or vomiting [epilepsysandiego.org]

They may however vomit or bite their tongue and can sometimes injure themselves if they hit nearby objects as they fall or convulse. [epilepsyaustralia.net]

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]

TONIC-CLONIC – ( grand mal) convulsive (Most often recognized, but only 10% of those with epilepsy have this type of seizure) Stiffens, may utter cry, loss of consciousness, falls, body jerking 1 – 3 minutes loss of bladder or bowel control or vomiting [epilepsysandiego.org]

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]

Tonic Clonic seizures (previously called grand mal seizures) During a tonic clonic seizure a person’s body stiffens, air being forced past the vocal cords causes a cry or groan and they fall to the ground (the tonic phase). [epilepsyqueensland.com.au]

He also noted forced laughter-crying episodes associated with this motor phenomenon when the contralateral thalamus was involved. Dana and other authors believed that the abnormal movements observed in pontine lesions were not convulsive in nature. [jamanetwork.com]

This cry does not indicate pain. 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]

ADVERSE REACTIONS The most common adverse reactions in patients receiving FYCOMPA ( 5% and 1% higher than placebo) include dizziness, somnolence, fatigue, irritability, falls, nausea, weight gain, vertigo, ataxia, headache, vomiting, contusion, abdominal pain [eisai.mediaroom.com]

Intramuscular paraldehyde should be avoided because the injection is painful, and there are risks of damaging the sciatic nerve and causing sterile abscesses. 6 The working party considered whether a second dose of rectal diazepam should be given in preference [adc.bmj.com]

Because of its high pH, extravasation of phenytoin can result in severe subcutaneous irritation (‘purple glove syndrome’) characterized by edema, discolouration and pain distal to the site of administration. [cps.ca]

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]

SOMNOLENCE AND FATIGUE FYCOMPA caused dose-dependent increases in somnolence and fatigue-related events. [eisai.mediaroom.com]

[Journal Article] Clin Neurol Neurosurg 2019; 183:105392 Eguchi K, Tsuzaka K, … Sasaki H CN A 33-year-old man developed a generalized tonic-clonic seizure after a week of fever and fatigue. [unboundmedicine.com]

The child should return to his or her normal self except for fatigue within around 15 minutes. Often the child may have incontinence (lose urine or stool), and it is normal for the child not to remember the seizure. [emedicinehealth.com]

To the contrary, hypoventilation can be easily lethal. [onlinelibrary.wiley.com]

Clinical correlates of PGES Autonomic dysfunction, manifested by postictal tachycardia and tachypnea, was commonly observed in our patients with GCS. [onlinelibrary.wiley.com]

Respiratory distress, manifested as hyperpnea with coarse breathing sounds, was common and appeared more prominent in patients with PGES. However, postictal central apnea was not observed in any patient. [onlinelibrary.wiley.com]

Moreover, Seyal et al. ( 2012b ) recently demonstrated that early periictal nursing intervention was associated with reduced duration of respiratory distress and reduced duration of PGES. [onlinelibrary.wiley.com]

Increased pressure on the bladder and bowel may cause wetting (urinary incontinence) or soiling (fecal incontinence). The child may bite the tongue, which may cause bleeding. The extremities will then jerk and twitch rhythmically ( clonic phase). [epilepsyontario.org]

Clinical correlates of PGES Autonomic dysfunction, manifested by postictal tachycardia and tachypnea, was commonly observed in our patients with GCS. [onlinelibrary.wiley.com]

Saliva that has not bene swallowed during the seizure may froth at the mouth. Breathing may be irregular as the respiratory muscles may be affected. The person will regain consciousness slowly. [epilepsyontario.org]

Increased pressure on the bladder and bowel may cause wetting (urinary incontinence) or soiling (fecal incontinence). The child may bite the tongue, which may cause bleeding. The extremities will then jerk and twitch rhythmically ( clonic phase). [epilepsyontario.org]

Her family observed 3 "severe shaking episodes" with urinary incontinence. Angiography showed proximal basilar artery stenosis. Silverstein 21 analyzed 83 autopsies of patients with pontine infarcts. Eleven (13%) had basilar artery occlusions. [jamanetwork.com]

Often the child may have incontinence (lose urine or stool), and it is normal for the child not to remember the seizure. Sometimes the jerking can cause injury, which may range from a small bite on the tongue to a broken bone. [emedicinehealth.com]

Increased pressure on the bladder and bowel may cause wetting (urinary incontinence) or soiling (fecal incontinence). The child may bite the tongue, which may cause bleeding. The extremities will then jerk and twitch rhythmically ( clonic phase). [epilepsyontario.org]

Her family observed 3 "severe shaking episodes" with urinary incontinence. Angiography showed proximal basilar artery stenosis. Silverstein 21 analyzed 83 autopsies of patients with pontine infarcts. Eleven (13%) had basilar artery occlusions. [jamanetwork.com]

Roll the child on his/her side after the seizure subsides. If a seizure lasts longer than five minutes or repeats without full recovery, seek medical assistance immediately. Talk gently to the person after the seizure. [epilepsyontario.org]

Abrupt seizure termination was defined as a sudden, bilateral, and synchronized electroclinical seizure termination, whereas a gradual seizure termination was defined as seizures that terminated slowly with nonconvulsive ictal discharges or seizures that [onlinelibrary.wiley.com]

Seizures also may be classified based on their cause such as, for example, febrile seizures, or seizures caused by high temperature, as well as symptoms they cause, myoclonic seizures, clonic seizures, tonic seizures, tonic-clonic seizures, absence seizures [dravetsyndromenews.com]

These seizures are known as focal aware seizures or focal impaired awareness seizures. [epilepsysociety.org.uk]

This types of seizure can be mistaken for drug/alcohol affected behavior or psychiatric disturbance. Focal dyscognitive seizures were previously known as complex partial seizures. At times focal seizures can evolve to become generalized seizures. [epilepsyqueensland.com.au]

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]

3 minutes loss of bladder or bowel control or vomiting possible breathing – during tonic phase, breathing may decrease or cease – causing cyanosis (bluing) of lips, face, nail beds – returns during clonic phase though may be irregular after seizure confusion [epilepsysandiego.org]

After the seizure, the person may be confused for a while, sometimes called ‘post-ictal’ (after-seizure) confusion. It may be hard to tell when the seizure has ended. The person might be tired, and want to rest. [epilepsysociety.org.uk]

Unfortunately, a great deal of misunderstanding and confusion about seizures still exists, so it is important that your child's friends and teachers become educated about her condition. [healthychildren.org]

The person may often appear confused and dazed and may do strange and repetitive actions like fiddling with their clothes, making chewing movements or uttering unusual sounds. [epilepsyqueensland.com.au]

Of the 151 GTCS, 2 (1.3%) were generalized tonic seizures, 28 (18.5%) were generalized clonic seizures, and 121 (80.1%) were generalized tonic clonic seizures (GTCS). [onlinelibrary.wiley.com]

[Journal Article] Clin Neurol Neurosurg 2019; 183:105392 Eguchi K, Tsuzaka K, … Sasaki H CN A 33-year-old man developed a generalized tonic-clonic seizure after a week of fever and fatigue. [unboundmedicine.com]

CONVULSIVE SEIZURE Generalized tonic-clonic seizures are typically bilateral and symmetric although variants with asymmetry including head and eye deviation can be seen. [epilepsydiagnosis.org]

• Specific provocation and rapid reorientation helps to distinguish syncope from generalized tonic clonic seizures. [medlink.com]

Generalized seizures account for approximately 40 percent of all epilepsy, with primary generalized tonic-clonic seizures being one of the most common and severe forms of generalized seizures. [eisai.mediaroom.com]

S/he may have a headache once s/he regains consciousness. There is no evidence that tonic-clonic seizures cause brain damage. First Aid Expand First Aid Section Keep calm. Protect the child from further injury. Do not restrain the person. [epilepsyontario.org]

They may have a headache and want to sleep. This drowsiness can last for a numbers of hours. Although this type of seizure can be frightening to watch, the seizure itself is unlikely to seriously harm the person having the seizure. [epilepsyqueensland.com.au]

They may feel tired or confused after the event and have a headache. Tonic seizures are very rare in Dravet syndrome. Tonic-clonic seizures Tonic-clonic seizures usually are generalized onset, but also can be focal onset. [dravetsyndromenews.com]

In all perampanel-treated subgroups, the most common TEAE was dizziness, and there were no notable differences in the types of TEAEs across subgroups, including somnolence and headache. [eisai.mediaroom.com]

[…] affected and become difficult or sound noisy their skin may change colour and become very pale or bluish they may wet themselves After the seizure (once the jerking stops): their breathing and colour return to normal they may feel tired, confused, have a headache [epilepsysociety.org.uk]

Focal seizures where the person retains full awareness of the event were previously called simple partial seizures. Focal seizures can also affect a person’s level of consciousness. In some focal seizures the person is in a dyscognitive state. [epilepsyqueensland.com.au]

Focal seizures can start in one area of the brain, and spread to involve both sides of the brain. In some instances a focal seizure can progress to a convulsive seizure. [healthychildren.org]

Some focal seizures involve movements, called motor symptoms and some involve unusual feelings or sensations called, non-motor symptoms. [epilepsysociety.org.uk]

PGES in a patient after a secondarily GCS (calibration bar: 1.0 s, 50 μV). ( A ) Abrupt seizure termination (as indicated by arrow) and followed by PGES. ( B ) Continued PGES subsequently evolved to postictal EEG slowing (as indicated by arrow). [onlinelibrary.wiley.com]

Poh et al. recently demonstrated that autonomic changes with seizures also appear to correlate with postictal EEG suppression. [onlinelibrary.wiley.com]

Comparing to clonic phase, tonic phase may cause more pronounced ictal apnea, leading to more pronounced postictal hypoxemia and hypercapnia. [onlinelibrary.wiley.com]