In this article, we will consider tonic-clonic seizures. 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 relatives or children are the victims of the disease. We will talk about what can cause seizures, how to get rid of them, and what treatment methods exist.
What it is?
Tonic-clonic convulsions are a form of convulsive syndrome that 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.
Convulsions themselves are not so dangerous and are a symptom of some more serious disease. However, during a seizure, a person can be seriously injured - hit, burns, cuts, chokes, if convulsive contractions begin during eating.
Stages
Tonic-clonic convulsions have several stages that the patient goes through during a seizure. They must be known not only to doctors, but also to relatives of the patient, since it is on their shoulders that first aid is laid. So, let's analyze in detail each stage of the seizure.
Aura
Tonic-clonic convulsions begin with the appearance of precursors. Some time before the onset of a seizure, certain omens appear. Usually the patient becomes withdrawn, irritable and lethargic. An unwarranted feeling of anxiety may appear. Aura can have a specific individual character. For example, in some patients, a few minutes before the onset of an attack, rainbow circles appear in front of the eyes.
Acres come in several forms:
- Auditory (auditory hallucinations appear).
- Visual.
- Motor (the appearance of obsessive movements).
- Mental (anger, depression).
- Flavoring (the appearance of taste sensations).
- Abdominal (stool disorders, abdominal pain).
- Vegetative (increased sweating, pallor or redness of the face).
- Deja vu.
- Nonspecific (no pronounced signs, a feeling of general discomfort).
This diversity is due to the fact that irritation occurs in various parts of the cerebral cortex, which is clearly visible on the EEG.
One way or another, all patients experience an approaching seizure. This period is called aura. In this phase, you can try to prevent an attack, for example, to avoid overwork and stress, take special medications. If the seizure is inevitable, then at least prepare a place, remove all dangerous objects, lie on a wide bed, turning your head to the side.
Complex fit
The second phase that appears after the aura. Tonic-clonic seizures are very long seizures that can exhaust the patient and his family.
During the onset of this phase, the patient loses consciousness. A person, if he stood, falls, which can cause various injuries. Often a fall is accompanied by various sounds that arise due to a spasm of the chest muscles and glottis. A grimace appears on the face, expressing the missing appearance. Eyes are open, but they look nowhere.
A complex seizure is divided into two stages: tonic and clonic.
During the tonic phase, which lasts literally a second, the patient’s body is very tense, and then bends in an arc, as the tone of the extensor muscles increases. Smooth muscles begin to contract, which leads to difficulty breathing, involuntary urination, and even bowel movements.
During the clonic phase, flexor muscles shrink. In this case, patients often bang their heads on the floor. Foam begins to stand out from the mouth. At this point, the patient can bite his lip, tongue, damage the mucous membrane of the oral cavity, break a tooth or swallow the tongue. To prevent the tongue from sticking, the head is turned to one side, and a spoon or spatula wrapped in cloth is inserted between the teeth. This phase lasts up to two minutes.
After the cramps are over, the sleep phase will begin, which can last from a couple of minutes to two hours. There are times when the patient does not go into sleep, but immediately proceeds to the next stage.
Post-seizure disorder
Generalized tonic-clonic convulsions do not end in the previous step. Having regained consciousness, the patient begins to perform unconscious actions, the so-called motor stereotypes, for example, trying to go somewhere, take something, get dressed. At the same time, the patient does not remember his seizure and what happens to him immediately after him. During this period, the patient must be reassured.
Hysteria attacks
The cause of such convulsions may be hysteria. The patient calls them in order to attract attention. Such attacks occur only with a large crowd of people. A patient with a fall never gets seriously injured. Harbingers will exist only if a patient with hysteria knows about their existence.
During seizures, consciousness is not lost, there are no pathological reflexes, normal reactions to various stimuli. Many patients can describe what happens to them during such seizures.
Another distinguishing feature - on the EEG there are no characteristic changes in brain activity. 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 does not end with a list of possible reasons. We list them:
- Various poisonings: methyl alcohol, alcohol, barbiturates, drugs, carbon monoxide, psychotropic substances, convulsive poisons (corazole, strychnine).
- Overdose of drugs (for example, "Ceftazidine", "Aminazine", "Isoniazid").
- Serious head injuries.
- Brain diseases leading to the appearance of tumors.
- Hepatic or renal failure.
- Rabies.
- Tetanus.
- Hypo-, hyperglycemia.
- Hyponatremia, hyperkalemia, hypo-, hypercalcemia.
- Coma and precoma.
- The harmful effects of ionizing radiation.
- Severe cases of hypothermia and hyperthermia. Often in children, with a rise in temperature above 38.6, convulsions begin.
- Very severe toxicosis during pregnancy.
- Dehydration in severe forms.
- Psychological trauma.
- Injuries resulting from electrical discharges.
All these reasons can provoke the onset of an attack in epileptics, which is very dangerous for the patient. The fact is that these factors can aggravate a state of health. High risk of the appearance of the so-called epileptic status. This pathology is characterized by the fact that against the background of what has already begun, the second can come, without stopping the first. This condition is extremely dangerous to health.
Seizures with epilepsy
One major symptom is epilepsy - tonic-clonic seizures. This disease is hereditary. At the same time, neuralgic examinations do not reveal any deviations.
In the case of inheritance, the disease begins to manifest at puberty. The first tonic-clonic seizures in children are slightly different from those described above. Their description is as follows:
- There is no aura.
- The seizure begins with a short tonic phase.
- The patient's legs are straightened, and his arms are slightly bent.
- Then diffuse tremor occurs.
- At the end of the tonic phase, vegetative changes often occur, blood pressure almost doubles, the heart begins to beat faster.
- The clonic stage begins.
Seizures with epilepsy are incurable. You can only try to stop them with the help of medications and prevent any unrest and upheaval.
Diagnosis of the disease
Generalized tonic-clonic seizures in themselves are an excellent diagnosis, however, additional examinations are needed to identify the exact cause of their appearance. In this case, it is necessary to exclude the hereditary transmission of the disease. Also, the patient’s relatives will need to describe the details of the attack to the attending 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 some parts of the brain.
- Computed tomography helps determine if various tumors or hemorrhages are causing the attacks.
- An X-ray of the cranial bones is performed only for traumatic brain injuries and suspicions of them. Allows you to verify the presence or absence of fractures and other injuries.
Tonic-clonic convulsions: treatment in adults and children
What to do when an attack occurs? First of all, it is necessary to observe certain preventive measures for traumatizing the patient, then try to stop the cramps. After the seizure, you need to contact your doctor so that he can diagnose and identify 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 injured. How to provide first aid, we have already described above. Now let's list what needs to be done after.
So, first, wait for the patient to regain consciousness. If the attack is not the first and they occur infrequently, then hospitalization is not required. If convulsions become more frequent, be sure to consult a doctor. Such changes can have very serious consequences.
There are also a number of drugs that can relieve a seizure. It:
- "Magnesia".
- "Sodium Osibutyrate" (GABA).
- Diazepam (benzodiazepines).
There is also differentiated therapy, depending on what caused the ailment:
- Patients with epilepsy for prophylactic purposes are often prescribed a course of "Phenobarbital" and "Carbamazepine." At the time of the attack, it is recommended to enter "Magnesia" and "Relanium".
- Seizures during prolonged binges are caused by water-electrolyte imbalance. Therefore, measures are being taken to normalize it.
- The period of pregnancy is the most dangerous. Firstly, a woman can cause physical injuries to a child during an attack, and secondly, the range of medicines is extremely limited. In this case, the doctor must find out the cause of their appearance and try to eliminate it. If this is not possible, then carry out all activities to maintain the health of mother and baby.
- With cramps in children caused by high temperature, it is urgently necessary to reduce it.
In addition to medicines, special massages, physiotherapy, and herbal medicine are prescribed to relieve and prevent seizures (valerian and motherwort broths have proven themselves).
People who are prone to seizures need to adhere strictly to the daily routine. There should not be any scandals and screams around. Sleep should be full, always at night. Watching movies and shows that can excite a person is minimized. Be sure to take daily walks in the fresh air in quiet areas.
Cramps in children
Tonic-clonic convulsions in a newborn, especially in premature babies, are a very common occurrence. Pathology caused is the process of formation of the nervous system. Usually, by the age of five years, seizures completely stop. Only in 5% of children do they remain and pass into epilepsy. However, only the attending physician can make a final diagnosis and make a prognosis, based on the frequency and duration of seizures, as well as their nature.
Generalized tonic-clonic seizures in children are of two types:
- Simple - lasts no more than 15 minutes, episodes are usually single (the minimum break is 24 hours).
- Complex - lasts longer than 15 minutes, while the seizure is repeated several times a day.
Complex convulsions are the most dangerous for babies, because they are the ones that can develop into epilepsy. Also at risk are children with prolonged, often recurring seizures, in which the first cramps appeared before the year, and pathological brain activity is noted on the EEG.
Children in this category must be put on a dispensary account by a neurologist. Parents should also be careful. The risk of an onset of an attack increases with diseases accompanied by fever. And this must be avoided by any means. Also, these children should not be overworked, placed in stressful situations, listen to loud music with them, and allow them to watch unlimited any kind of films and cartoons.
How to help a child with cramps?
Tonic-clonic seizures in children develop in approximately the same way as in adults. The only significant difference is that they often occur suddenly, without any precursors. Therefore, parents should always be ready to provide the child with first aid.
In no case do not try to bring the child to life, it is impossible to stop the seizure. Better not let him fall during a loss of consciousness and remove all sharp objects. If convulsions recur frequently, be sure to carry a spoon with you that can be placed between the teeth to prevent the child from swallowing the tongue.