Generalized tonic-clonic convulsions

In this article we will consider tonic-clonic convulsions. Any seizures cause the one who sees them, panic and horror. A person is often lost and does not even know how to provide first aid. The situation worsens if the victim of the disease are relatives or children. About what can cause seizures, how to get rid of them and what methods of treatment exist, let's talk below.

What it is?

Tonic-clonic convulsions are a form of convulsive syndrome, which is accompanied by loss of consciousness. Often the cause of this seizure is epilepsy.

In fact, this type of seizure indicates a nonspecific reaction of the brain to some action of stimuli.

The convulsions themselves are not so dangerous and are a symptom of some more serious disease. However, during a seizure, a person can seriously injure themselves - hit, burn, cut, choke if the convulsive contractions began during meals.

Stages of

Tonic-clonic convulsions have several stages that the patient passes through during a seizure. They must be known not only to doctors, but also to the patients' relatives, since it is on their shoulders that the first medical aid lies. So, let's take a closer look at each stage of the seizure.

Aura

Tonic-clonic seizures begin with the appearance of harbingers. Some time before the onset of seizures, some omens appear. Usually the patient becomes withdrawn, irritable and listless. There may be an unjustified sense of anxiety. Aura can be of a specific individual character. For example, in some patients, a few minutes before the onset of an attack, rainbow circles appear before your eyes.

Acres come in several forms:

• Auditory (there are auditory hallucinations).
• Visual.
• Motor (the appearance of compulsive movements).
• Mental (anger, depression).
• Taste (the appearance of taste sensations).
• Abdominal (disorders of stool, abdominal pain).
• Vegetative (increased sweating, pallor or redness of the face).
• Déjà vu.
• Nonspecific (no pronounced signs, a feeling of general discomfort).

This diversity is due to the fact that irritation occurs in different parts of the cerebral cortex, which is clearly visible on the EEG.

Anyway, all patients feel the approach of a seizure. This period is called "aura". In this phase, you can try to prevent an attack, for example, avoid overwork and stress, take special medications. If the attack is inevitable, then at least prepare a place, remove all dangerous items, lie on a wide bed, turning his head to one side.

Comprehensive fit

The second phase that appears after the aura. Tonic-clonic seizures are very long-lasting seizures that can wear out not only the patient, but also his relatives.

At the beginning of this phase, the patient loses consciousness. A person, if he stood, falls, which can lead to various injuries. Often the fall is accompanied by various sounds that arise from the spasm of the muscles of the chest and the glottis. On the face there is a grimace, expressing an absent kind. Eyes are open, but they look to nowhere.

The complex fit is divided into two stages: tonic and clonic.

During the tonic phase, which lasts literally seconds, the body of the patient strongly strains, and then arches, as the tone of the extensor muscles rises. Smooth muscles begin to contract, which leads to difficulty breathing, involuntary urination and even defecation.

During the clonic phase convulsively contract flexor muscles. In this case, patients often bang their heads on the floor. From the mouth foam starts to be allocated. At this point, the patient can bite the lip, tongue, damage the oral mucosa, break the tooth or swallow the tongue. To prevent the tongue from falling, the head is turned sideways, and a spoon or spatula, wrapped in tissue, is inserted between the teeth. This phase lasts up to two minutes.

After the convulsions are over, a phase of sleep will occur, which can last from a couple of minutes to two hours. There are cases when the patient does not fall asleep, but immediately moves on to the next stage.

Post-infection disorder

Generalized tonic-clonic convulsions do not end at the previous stage. When he regains consciousness, the patient begins to perform unconscious actions, the so-called motor stereotypes, for example, tries to go somewhere, take something, put on clothes. Thus the patient does not remember the seizure and that occurs or happens to it or him right after it or him. During this period, the patient must be reassured.

Attacks caused by hysteria

The cause of such cramps can be hysteria. The patient calls them in order to attract attention. Such attacks take place only with a large crowd of people. A patient who falls down never gets serious injuries. Harbinger will exist only if a patient with hysteria knows about their existence.

During convulsions, consciousness is not lost, pathological reflexes are absent , reactions to various kinds of irritants are normal. Many patients can describe what happens to them during such seizures.

Another distinguishing feature is that there are no characteristic changes in brain activity on the EEG. Involuntary urination and defecation are absent. There is no pathological sleep. The attack itself lasts much longer.

Tonic-clonic convulsions: causes

The main causes of seizures of this type are epilepsy and hysteria. But this list of possible causes is not exhausted. We list them:

• Various poisoning: methyl alcohol, alcohol, barbiturates, drugs, carbon monoxide, psychotropic substances, convulsive poisons (corazole, strychnine).
• Overdose with medicines (eg, "Ceftazidine", "Aminazine", "Isoniazid").
• Serious craniocerebral trauma.
• Diseases of the brain, leading to the appearance of tumors.
• Hepatic or renal insufficiency.
• Rabies.
• Tetanus.
• Hypo-, hyperglycemia.
• Hyponatremia, hyperkalemia, hypo-, hypercalcemia.
• Coma and precom.
• The harmful effect of ionizing radiation.
• Severe cases of hypothermia and hyperthermia. Often in children with fever above 38.6, convulsions begin.
• Very severe toxemia during pregnancy.
• Dehydration in severe forms.
• Psychological trauma.
• Injuries received from electrical discharges.

All these reasons can trigger the onset of an attack in epileptics, which is very dangerous for the patient. The fact is that these factors can aggravate the state of health. There is a high risk of the appearance of a so-called status epilepticus. This pathology is characterized by the fact that, against the background of the already begun, a second one may come, without stopping the first. This condition is extremely dangerous for health.

Seizures in epilepsy

One major symptom is epilepsy - tonic-clonic convulsions. This disease is hereditary. However, neuralgic examinations do not reveal any abnormalities.

In the case of inheritance, the disease begins to manifest itself at pubertal age. The first tonic-clonic convulsions in children differ slightly from those described above. Their description is as follows:

• There is no aura.
• The seizure begins with a short-term tonic phase.
• The legs of the patient are straightened, and the arms are slightly bent.
• Then comes a diffuse jitter.
• At the end of the tonic phase, vegetative changes often appear, blood pressure almost doubles, the heart starts to beat faster.
• The clonic stage begins.

Seizures in epilepsy are incurable. They can only be tried with medicines and prevented any disturbances and shocks.

Diagnosis of the disease

Generalized tonic-clonic convulsions themselves are an excellent diagnosis, however, additional tests are needed to identify the exact cause of their appearance. At the same time, hereditary transmission of the disease must be excluded. Also, the patient's relatives will need to describe the details of the attack to the treating physician - the patient himself, of course, will not remember them.

Here are the main research methods:

• Electroencephalography (EEG) allows you to see the pathological manifestations of the activity of certain parts of the brain.
• Computed tomography helps to determine whether seizures are caused by various tumors or hemorrhages.
• X-rays of the cranial bones are performed only with craniocerebral trauma and suspicion of them. Allows you to verify the presence or absence of fractures and other damages.

Tonic-clonic convulsions: treatment in adults and children

What should I do if I have an attack? First of all, it is necessary to follow certain preventive measures to traumatize the patient, then try to stop the seizures. After the end of the seizure, you need to contact your doctor to diagnose and diagnose the cause of the disease.

Treatment of tonic-clonic seizures, if they were caused by epilepsy or another chronic disease, is impossible. The only thing that can be done in such a situation is to protect the patient as much as possible from getting injuries. How to render first aid, we have already described above. Now let's list what needs to be done after.

So, first, wait for the patient to come to consciousness. If the attack is not the first and they occur infrequently, then hospitalization is not required. If convulsions become frequent, be sure to see a doctor. Such changes can have very serious consequences.

There are also a number of drugs that can remove a seizure. It:

• "Magnesia".
• "Sodium isobutyrate" (GABA).
• "Diazepam" (benzodiazepines).

There is also differentiated therapy depending on what caused the onset of the disease:

• Patients with epilepsy for preventive purposes are often prescribed a course of "Phenobarbital" and "Carbamazepine". At the time of attack it is recommended to enter "Magnesia" and "Relanium".
• Seizures during long drinking-bouts are caused by water-electrolyte imbalance. Therefore, take measures to normalize it.
• The period of pregnancy is the most dangerous. First, a woman can physically injure a child during an attack, and secondly, the spectrum of medicines is extremely limited. In this case, the doctor must find out the reason for their appearance and try to eliminate it. If this is not possible, then carry out all activities to preserve the health of mom and baby.
• When cramping in children caused by high temperature, it is necessary to urgently reduce it.

In addition to medicines, special massages, physiotherapy, and phytotherapy are prescribed for the removal and prevention of seizures (well-known valerian and motherwort decoctions are well established).

People who are prone to attacks need to strictly observe the regime of the day. There should not be any scandals and screams around. Sleep should be full, always at night. Viewing movies and programs that can excite a person is minimized. It is necessary to walk daily outdoors in quiet areas.

Convulsions in children

Tonic-clonic seizures in the newborn, especially in premature infants, are very common. The pathology is caused by the process of the formation of the nervous system. Usually by the age of five, seizures completely cease. Only 5% of children they remain and go into epilepsy. However, the final diagnosis and prognosis can only be made by the attending physician, based on the frequency and duration of seizures, and also on their nature.

Generalized tonic-clonic convulsions in children come in two forms:

• Simple - last no more than 15 minutes, episodes are usually single (minimum break - 24 hours).
• Complicated - last longer than 15 minutes, while the seizure is repeated several times a day.

Complex convulsions are the most dangerous for babies, because they are able to develop into epilepsy. Also at risk are children with long, often recurring attacks, in which the first convulsions appeared even before the year, and the EEG shows abnormal brain activity.

Children belonging to this category, necessarily put on dispensary records to a neurologist. Parents should also show increased attention. The risk of the onset of an attack increases with diseases accompanied by an increase in temperature. And this must be avoided by any means. Also, these children can not be overworked, put in stressful situations, listen to loud music with them, allow them to watch any kind of films and cartoons unlimitedly.

How to help a child with cramps?

Tonic-clonic convulsions in children develop approximately the same as in adults. The only significant difference is that often they come suddenly, without any precursors. Therefore, parents should always be ready to provide the child with first aid.

Do not try to bring the child to life, it is impossible to stop the seizure. Better do not let it fall during a loss of consciousness and remove all sharp objects. If the cramps are repeated often, be sure to carry a spoon with you, which can be placed between the teeth to prevent the child from swallowing the tongue.