Posts Tagged Tonic clonic seizure

[ARTICLE] Electroencephalography in the Diagnosis of Genetic Generalized Epilepsy Syndromes – Full Text

Genetic generalized epilepsy (GGE) consists of several syndromes diagnosed and classified on the basis of clinical features and electroencephalographic (EEG) abnormalities. The main EEG feature of GGE is bilateral, synchronous, symmetric, and generalized spike-wave complex. Other classic EEG abnormalities are polyspikes, epileptiform K-complexes and sleep spindles, polyspike-wave discharges, occipital intermittent rhythmic delta activity, eye-closure sensitivity, fixation-off sensitivity, and photoparoxysmal response. However, admixed with typical changes, atypical epileptiform discharges are also commonly seen in GGE. There are circadian variations of generalized epileptiform discharges. Sleep, sleep deprivation, hyperventilation, intermittent photic stimulation, eye closure, and fixation-off are often used as activation techniques to increase the diagnostic yield of EEG recordings. Reflex seizure-related EEG abnormalities can be elicited by the use of triggers such as cognitive tasks and pattern stimulation during the EEG recording in selected patients. Distinct electrographic abnormalities to help classification can be identified among different electroclinical syndromes.


Genetic generalized epilepsy (GGE) encompasses several electroclinical syndromes diagnosed and classified according to clinical features and electroencephalographic (EEG) characteristics (13). The EEG hallmark of GGE is bilateral synchronous, symmetrical, and generalized spike-wave (GSW) discharges. Polyspikes and polyspike-wave discharges are also commonly seen in GGE. Fixation-off sensitivity (FOS), eye-closure sensitivity, photoparoxysmal response (PPR), epileptiform K-complexes/sleep spindles, and occipital intermittent rhythmic delta activity (OIRDA) are among the spectrum of abnormalities described in GGE (4).

In this review, we will be discussing the ictal and the interictal EEG abnormalities in GGE. We will also focus on the electrographic differences among different GGE syndromes, factors affecting the yield of EEG, and diagnostic pitfalls.[…]

Continue —> Frontiers | Electroencephalography in the Diagnosis of Genetic Generalized Epilepsy Syndromes | Neurology


Figure 1. Typical interictal epileptiform discharges in genetic generalized epilepsy. Note bilateral, symmetrical, and synchronous spike-wave discharges (A), polyspike-wave discharges (B), and polyspikes (C).


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[WEB SITE] Generalized Tonic-Clonic Seizure or Grand Mal Seizure

Generalized tonic-clonic seizure is also known as grand mal seizure, this seizure occurs when there is any disturbance in the functioning of both sides of the brain. Due to this disturbance, electrical signals are transmitted to the nerves, muscles and glands resulting in loss of consciousness and severe muscle contractions which are known as seizures. Seizures can also occur when a patient is suffering from epilepsy, has high fever, injury/trauma to the head or is hypoglycemic. Sometimes individuals can have seizures when they are going through withdrawal from alcohol or drug addiction.

Generalized Tonic-Clonic Seizure or Grand Mal Seizure

Tonic-clonic seizures are named so due to their two distinctive stages. In the tonic stage, the patient loses consciousness and can fall down. In the clonic stage, the patient has rapid contractions of the muscles, which are also known as convulsions. The clonic stage usually lasts for around two minutes or even less.

Patients suffering from epilepsy will have generalized tonic-clonic seizures during late childhood or adolescent age. Sometimes, a seizure can occur on a one time basis, which is not related to epilepsy and this could happen to a person of any age. These seizures commonly occur from a triggering event, which temporarily changes the functioning of the brain.

A generalized tonic-clonic seizures or grand mal seizure can be a medical emergency and medical treatment should be sought immediately. Tonic-Clonic Seizure Treatment comprises of antiepileptic medications, surgery and alternative therapies.

Causes of Generalized Tonic-Clonic Seizure or Grand Mal Seizure

The cause behind generalized tonic-clonic seizures is a variety of health conditions, which include:

  • Low levels of glucose, calcium, magnesium or sodium in the body.
  • Abuse or overconsumption of alcohol or drugs.
  • Withdrawal from alcohol or drugs.
  • Trauma or injury to the head.
  • Certain neurological disorders or genetic conditions.
  • Brain tumor.
  • Stroke or a ruptured blood vessel in the brain.
  • Sometimes the exact cause behind the onset of seizures cannot be found.

Risk Factors For Generalized Tonic-Clonic Seizure or Grand Mal Seizure

  • Having a family history of epilepsy.
  • Having a brain injury, stroke or infection.
  • Sleep deprivation.
  • Electrolyte imbalances.
  • Drug or alcohol overuse.

Signs & Symptoms of Generalized Tonic-Clonic Seizure or Grand Mal Seizure

  • Patient may have a strange sensation or a feeling, which is also known as an aura.
  • Patient may involuntarily cry out or scream.
  • Loss of bladder and bowel control either during the seizure or after the seizure.
  • Patient may pass out and wake up feeling sleepy or confused.
  • Patient can also experience severe headache after having the seizure.
  • During the actual generalized tonic-clonic seizure, the patient becomes rigid and falls down during the tonic stage. Then the muscles of the face and limbs will convulse causing rapid and jerky movements.
  • After having generalized tonic-clonic seizure patient may feel sleepy or confused for many hours before completely recovering.

Investigations & Diagnosis of Generalized Tonic-Clonic Seizure or Grand Mal Seizures

Medical history and physical exam, where the doctor will ask about other medical conditions, seizures etc. The doctor will ask about any triggering events before the seizure.

Neurological exam is performed to check for reflexes, balance and coordination. The tone and strength of the muscles is also assessed along with how the patient holds and moves his/her body. Patient’s judgment and memory are also assessed.

  • Blood tests are done to look for other medical problems, which can trigger the seizure.
  • Medical imaging is done to monitor the brain function and these include electroencephalogram (EEG), magnetic resonance imaging (MRI) and brain scans.

Treatment for Generalized Tonic-Clonic Seizure or Grand Mal Seizure

If the patient has had one grand mal seizure, which is not repeated then it may be an isolated event and commonly does not need treatment. The patient will be monitored on a regular basis. Treatment for Generalized Tonic-Clonic Seizures or Grand Mal Seizure comprises of:

Antiepileptic Medications For Generalized Tonic-Clonic Seizure or Grand Mal Seizure

Most of the times, the seizures are managed with medications, which are started on a low dose of a single drug. The dosage is slowly increased as required. There are some patients who need more than one medication for treating their seizures. It takes time to find out the most effective type of medication and the right dosage of that medication. Medications used to treat epilepsy are: Oxcarbazepine (Trileptal), lamotrigine (Lamictal), carbamazepine (Tegretol), lorazepam (Ativan) and phenytoin (Phenytek, Dilantin).

Surgery For Generalized Tonic-Clonic Seizure or Grand Mal Seizure

If the medications are not effective in controlling the seizures, then surgery of the brain may be done. This option is effective in partial seizures which affect only a small part of the brain.

Supplemental or Alternative Treatments For Generalized Tonic-Clonic Seizure or Grand Mal Seizure

Alternative or supplemental treatment for grand mal seizures include vagus nerve stimulation where an electrical device is implanted which automatically stimulates a nerve in the neck. Also, consumption of a ketogenic diet, which is high fat and low in carbohydrates, can help some patients in controlling the seizures.

Prevention of Generalized Tonic-Clonic Seizure or Grand Mal Seizure

  • Sometimes seizures can be prevented if the triggering factors for them are identified. Certain steps can be taken in daily life to prevent seizures and these include:
  • Using safety belts, helmets and automobile airbags while driving to avoid traumatic brain injury.
  • Consumption of food, which is prepared with proper hygiene and food handling to avoid infections which cause epilepsy.
  • Trying to reduce the risk factors for stroke, such as hypertension, high cholesterol, sedentary lifestyle and smoking.
  • Adequate prenatal care should be sought by pregnant women to avoid complications which can cause a seizure disorder in the fetus. After the baby is born, it is important to immunize the child against diseases which can harm the central nervous system and cause seizure disorders.

Pramod KerkarWritten, Edited or Reviewed By: , MD,FFARCSI

Last Modified On: May 3, 2016

Pain Assist Inc.


Source: Generalized Tonic-Clonic Seizure or Grand Mal Seizure


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[VIDEO] Types of Seizures

Types of Seizures

Expert: Robert S. Fisher, M.D. Professor of Neurology Stanford University »

Seizures is a medical condition that is divided into two types. Watch our video to learn in detail about the different types of seizures and how to manage them.


The word “seizure” is used to describe the medical condition in which too many brain cells become excited simultaneously, but there are actually so many that neurologists are still updating how to classify them. Usually, they classify seizures into two main types, partial seizures and primary generalized seizures.

The difference between these types is in how they begin: Partial seizures, which begin in a single part of the brain, are further described by two additional criteria.

  1. The first is whether awareness, memory, and consciousness are preserved during the seizure. If they all are preserved, then a seizure is called “simple partial.”
  2. However, if any are impaired then the seizure is called “complex partial.”

The impact of a partial seizure depends on where in the brain it originates, and how it spreads. Partial seizures sometimes have an aura, which is a warning that bigger seizures may follow. An aura usually occurs seconds to minutes before seizure, but some patients can have periods of warning lasting a day or longer. Technically, the aura is itself a small simple partial seizure. There are many different ways in which people experience an aura. The start of a seizure in one of the temporal lobes can produce unusual feelings, like abnormal sensation or forced thinking. The onset of a complex partial seizure may be heralded by deja vu, a familiar feeling, or jamai vu, an unfamiliar feeling. Some patients have auras of sounds, tastes, distorted vision, racing thoughts, or smells, like burning rubber. Physical sensations occurring as auras are dizziness, headache, lightheadedness, and numbness. An upset stomach is a particularly common phsycial symptom. Auras can include a sense of tingling rising up the body or other strange feelings difficult to describe. Distorted emotions, like fear or panic, can also be a seizure warning. However, some complex partial seizures occur without any remembered warning. Primarily generalized seizures begin with a widespread electrical discharge that involves both sides of the brain at once. Partial seizures begin with an electrical discharge in one limited area of the brain. All generalized seizures begin with synchronous electrical activity throughout the brain accompanied by sudden generalized movements or loss of consciousness.

However, there are still many different types of generalized seizure. A tonic-clonic seizure, once called a “grand mal,” is what most people think of when they hear the word “seizure.” When someone experiences a tonic-clonic seizure, first they stiffen and lose consciousness, which is the “tonic” phase. Then, they begin jerking, which lasts for several minutes and is called the “clonic” phase.

Sometimes seizures don’t have a tonic stiffening and clonic jerking sequence, but are just tonic seizures or clonic seizures.

  1. Other types of generalized seizure include absence seizures, when the sufferer “disconnects” from the world for a few seconds,
  2. myoclonic seizures, which cause jerking, but just for a second or two,
  3. and atonic seizures, which cause people to lose all muscle tone and drop to the ground.

Understanding the different types of seizures can be helpful, but many people want more detailed information. The next two videos in this series provide an in-depth look at the effect of partial seizures on different parts of the brain and the different types of generalized seizures. “The movies in this series can be viewed in any order. If you wish to watch these clips in their original sequence, the next clip is, “Understanding the Different Types of Partial Seizures.”

via Types of Seizures | Healthguru.

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[WEB SITE] How to Help Someone Who Is Having a Seizure

seizure migrains Stock_adventtrWhen someone is having is seizure, they will often experience involuntary movement, changes in behavior, and awareness for lasting a couple minutes to an hour. If you’ve never witnessed a seizure, you might be shocked, confused, scared, worried, or all of the above. The most important thing, however, is for you to remain calm.

Know the circumstances under which you should call for emergency medical services. If you are concerned for the person’s safety and feel unable to help the person, you should call for emergency medical attention, but in many cases, a person having a seizure will not need emergency assistance. Often, a person will have medication with them. Ask when you can. This is helpful and can be useful to them right away. Get emergency assistance if:

  1. The person doesn’t have a MedicAlert necklace or bracelet that says “epilepsy” or “seizure”.
  2. The seizure occurred in water.
  3. A seizure occurs after the person complains of a sudden, severe headache or if it follows a head injury
  4. A seizure occurs after inhaling fumes or poison
  5. A seizure occurs with other signs of stroke, such as trouble speaking or understanding speech, loss of vision, and inability to move part or all of one side of the body.
  6. They are pregnant, hurt, or have a necklace or bracelet that says “diabetic”.
  7. The seizure lasts more than 3 minutes
  8. A second seizure starts shortly after the first one stops, or if the person has already had a seizure in the past 24 hours.
  9. The person stops breathing for more than 30 seconds
  10. An hour after the seizure stops, the person does not respond normally or suffers from reduced awareness, drowsiness, confusion, nausea or vomiting, fever, or an inability to walk/stand.

Continue —>  How to Help Someone Who Is Having a Seizure | Cancer Facts Central.

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