Clonic seizures: symptoms and treatment. What are the dangers of clonic and tonic seizures? Description of generalized tonic-clonic epileptic seizures

Many have experienced seizures. Often they suddenly appear and also suddenly disappear. For some people, muscle cramps happen quite rarely, while for others they recur frequently and can last from three to fifteen minutes. If the convulsive syndrome is repeated several times a week, then a doctor's consultation in this case is required. Perhaps this is just a lack of vitamins, or maybe spasms indicate the development of some serious illness. A doctor can help you sort out this problem.

Muscle spasms are divided into several varieties. But most often, tonic, clonic and complicated clonic-tonic convulsions are diagnosed. Despite the fact that these varieties characterize involuntary muscle contractions and algia, they still have a number of significant differences.

They can occur under the influence of various adverse factors, which mainly indicate any disturbances in the body. Despite the fact that muscle contractions are quite common, they most often affect only a few muscle groups.

Tonic convulsions are characterized by short-term contractions of muscle areas with the onset of slow spasms that provoke a strong overstrain of muscle fibers.

Only the attending physician will be able to tell about everything else, who will establish a diagnosis and prescribe a course of treatment, subject to which convulsive seizures can remain in the past. And do not forget that your life and health depend on the timely visit to the doctor.

convulsions- these are involuntary muscle contractions that appear suddenly in the form of seizures and continue for a different duration.
There are clonic, tonic and clonic-tonic convulsions.

Clonic convulsions- fast muscle contractions that follow each other after a short period of time. They can be rhythmic and non-rhythmic and are characterized by excitation of the cerebral cortex.
tonic convulsions- prolonged muscle contractions. They come on slowly and last for a long time. Their appearance indicates the excitation of the subcortical structures of the brain.
Seizures in epilepsy, traumas of the skull, organic diseases of the brain are clonic-tonic, and with tetanus - tonic.

Recognition convulsive attack usually presents no difficulty.
epileptic seizure. The patient suddenly loses consciousness. The look is wandering, the eyeballs first "float", and then are fixed upward or to the side. The head is thrown back, the arms are bent at the hands and elbows, the legs are extended, the jaws are convulsively closed. Breathing and pulse slow down, biting of the tongue, apnea is possible. The patient's face first turns pale, then becomes purplish blue. The tonic phase of convulsions lasts no more than a minute. The second phase of the seizure is characterized by clonic convulsions, in which flexion and extension of the muscles of the arms and legs, twitching of the muscles of the face, neck, and torso quickly alternate (the patient "beats"). Often there is involuntary urination. Foamy saliva comes out of the mouth. The total duration of the seizure is 2-3 minutes, then the muscles of the limbs and torso relax. Consciousness remains confused for a while, then sleep usually follows. Waking up, the patient does not remember what happened, complains of fatigue, muscle pain, weakness, headache.

convulsive seizure in epilepsy, the so-called aura (harbinger) is often preceded, which is manifested by palpitations, dizziness, a feeling of heat, unpleasant odors, perception of various sounds, a feeling of fear, etc.
Finding out causes of seizures, their differentiated diagnosis is carried out in stationary conditions - usually in a neurological clinic (or is decided together with a neuropathologist). Sometimes epileptic seizures have to be differentiated from hysterical.

Tactics of conducting patient with convulsive syndrome consists of emergency life-saving care and transportation to a neurological (psycho-neurological) department or to an infectious disease clinic (tetanus, rabies, acute infections).
Treatment of a convulsive syndrome. Experimental data show that after 60 min. convulsive status in a number of areas of the cortex and subcortex, irreversible cell damage occurs. In addition, according to clinical studies, the longer the attack lasts, the more difficult it is to stop it and the higher the frequency of neurological complications. Therefore, it is important to recognize and treat aggressively in the early stages, i.e. before such consequences develop.

First Aid for Seizures

Treatment should be comprehensive and directed:
to maintain vital functions;
elimination of seizures;
reduction of intracranial hypertension.

I. Maintaining the functions of vital organs: ensuring free airway patency; protection of the patient from possible trauma during convulsions.

II. Anticonvulsant therapy:
magnesium sulfate - 25% solution 10-25 ml in/in or/m; chlorpromazine 2.5% solution 2 ml / m;
seduxen (diazepam) - 10-20 mg per 20 ml of 40% glucose solution IV; barbiturates (hexenal, thiopental up to 1 g per day - 300-500 mg intravenously, the rest of the dose - intramuscularly); phenobarbital loading dose (15-20 mg/kg) is administered at a rate not exceeding 50-100 mg/min until the highest dose is reached or convulsions stop. The loading dose is followed by a maintenance dose of 1-4 mg/kg/day.
Sometimes anesthesia is used with nitrous oxide and oxygen in a ratio of 3:1.

III. Reducing intracranial pressure and reducing the hydrophilicity of the brain tissue:
osmotic diuretics (mannitol), lasix;
magnesium sulfate repeatedly;
spinal puncture;
glucocorticoids - preferably dexamethasone.

When convulsions docked, it is important to establish their etiology.
Convulsive syndrome is a consequence of damage to the central nervous system.
Depending on the alleged reasons, in the absence of the need for resuscitation at this stage of the patient's management, the issues of transporting the patient to specialized clinics are determined.

In this article, we will look at tonic-clonic seizures. Any seizures cause panic and horror in the one who sees them. 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. About what can cause seizures, how to get rid of them and what treatment methods exist, we will talk below.

What it is?

Tonic-clonic convulsions are a type that is accompanied by loss of consciousness. Often the cause of such a seizure is epilepsy.

In fact, this type of seizure indicates a non-specific reaction of the brain to some kind of stimulus.

Seizures 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, burn, cut, choke, if convulsive contractions began during a meal.

stages

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

Aura

Tonic-clonic seizures 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 unreasonable feeling of anxiety may appear. The aura can have a specific-individual character. For example, in some patients, a few minutes before the onset of an attack, rainbow circles appear before the eyes.

Acres are of several types:

• Auditory (auditory hallucinations appear).
• Visual.
• Motor (the appearance of obsessive movements).
• Mental (anger, depression).
• Taste (the appearance of taste sensations).
• Abdominal (stool disorders, pain in the abdomen).
• Vegetative (excessive 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 different parts of the cerebral cortex, which is clearly visible on the EEG.

One way or another, 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 an attack is inevitable, then at least prepare a place, remove all dangerous objects, lie down on a wide bed, turning your head to one side.

complex seizure

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

During the beginning of this phase, the patient loses consciousness. A person, if he was standing, falls, which can cause various injuries. Often a fall is accompanied by various sounds that occur due to spasm of the muscles of the chest and glottis. A grimace appears on the face, expressing an absent look. Eyes open, but looking nowhere.

A complex seizure is divided into two stages: tonic and clonic.

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

During the clonic phase, the flexor muscles contract convulsively. In this case, patients often beat their heads on the floor. Foam starts to come out of the mouth. At this point, the patient may tongue, damage the oral mucosa, break a tooth, or swallow the tongue. To prevent the tongue from sinking, 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 cases when the patient does not fall into sleep, but immediately moves on to the next stage.

post-seizure disorder

Generalized tonic-clonic seizures do not end in the previous stage. Having come to his senses, the patient begins to perform unconscious actions, the so-called motor stereotypes, for example, he tries 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 it. During this period, the patient must be reassured.

Attacks caused by hysteria

The cause of such convulsions may be hysteria. The patient himself calls them in order to attract attention. Such attacks pass only with a large crowd of people. A patient who falls never gets seriously injured. Harbingers will only exist if the hysteric is aware of their existence.

During convulsions, consciousness is not lost, there are no reactions to various kinds of stimuli, normal. Many patients can describe what happens to them during these 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 this type of seizures are epilepsy and hysteria. But this list of possible reasons is not exhausted. Let's list them:

• Various barbiturates, narcotics, carbon monoxide, psychotropic substances, convulsive poisons (corazol, strychnine).
• Overdose of drugs (for example, "Ceftazidine", "Aminazin", "Isoniazid").
• Serious traumatic brain injury.
• Diseases of the brain leading to the appearance of tumors.
• Liver or kidney 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, when the temperature rises above 38.6, convulsions begin.
• Very severe toxicosis during pregnancy.
• Dehydration in severe forms.
• Psychological trauma.
• Injuries received 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 the state of health. The risk of occurrence of the so-called epileptic status is high. This pathology is characterized by the fact that against the background of what has already begun, the second can occur, without stopping the first. This condition is extremely dangerous to health.

Seizures in epilepsy

One main symptom of epilepsy is tonic-clonic convulsions. This disease is hereditary. At the same time, neuralgic examinations do not reveal any abnormalities.

In the case of inheritance, the disease begins to manifest itself at puberty. The first tonic-clonic seizures in children are slightly different from those described above. Their description is as follows:

• No aura.
• The seizure begins with a brief tonic phase.
• The patient's legs are straightened, and the arms are slightly bent.
• Then comes diffuse trembling.
• At the end of the tonic phase, vegetative changes often appear, blood pressure almost doubles, and the heart begins to beat faster.
• The clonic stage begins.

Seizures in epilepsy are incurable. You can only try to stop them with the help of medicines and prevent any unrest and upheaval.

Diagnosis of the disease

Generalized tonic-clonic seizures are an excellent diagnosis on their own, but additional tests are needed to determine the exact cause of their occurrence. In this case, it is necessary to exclude the hereditary transmission of the disease. Also, the patient's relatives will definitely 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:

• allows you to see the pathological manifestations of the activity of certain parts of the brain.
• Computed tomography helps to determine whether various tumors or hemorrhages are the cause of the attacks.
• An X-ray of the cranial bones is performed only with craniocerebral injuries and suspicions of them. Allows you to verify the presence or absence of fractures and other injuries.

Tonic-clonic seizures: treatment in adults and children

What to do in the event of an attack? First of all, it is necessary to observe certain preventive measures for traumatizing the patient, then try to stop the convulsions. After the seizure ends, 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 not possible. The only thing that can be done in such a situation is to protect the patient as much as possible from injury. How to provide first aid, we have already described above. Now let's list what needs to be done after.

So, for starters, wait for the patient to regain consciousness. If the attack is not the first and they occur infrequently, then hospitalization is not required. If the seizures 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. This:

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

There is also a differentiated therapy, depending on what caused the disease:

• For prophylactic purposes, patients with epilepsy are often prescribed a course of Phenobarbital and Carbamazepine. At the time of the attack, it is recommended to inject "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 injury 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 take all measures to preserve the health of the mother and baby.
• With convulsions in children caused by high fever, it is urgent to reduce it.

In addition to medicines for the removal and prevention of seizures, special massages, physiotherapy, herbal medicine are prescribed (decoctions of valerian and motherwort have proven themselves well).

People prone to seizures 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. Watching movies and programs that can excite a person is minimized. Be sure to walk daily in the fresh air in quiet areas.

Seizures in children

Tonic-clonic convulsions in the newborn, especially in premature babies, are very common. Pathology is caused by the process of formation of the nervous system. Seizures usually stop completely by the age of five. Only in 5% of children they remain and turn 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 - 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.

Complicated seizures are the most dangerous for babies, because they are the ones who can develop into epilepsy. Also at risk are children with prolonged, often recurring seizures, in whom the first convulsions appeared before the age of one, and pathological brain activity is noted on the EEG.

Children belonging to this category are necessarily put on a dispensary account with a neurologist. Parents should also be extra vigilant. The risk of onset of an attack increases with diseases accompanied by fever. And this must be avoided by all means. Also, such children should not be overtired, placed in stressful situations, listen to loud music with them, allow them to watch any kind of films and cartoons without restriction.

How to help a child with seizures?

Tonic-clonic seizures in children develop in much the same way as in adults. The only significant difference is that they often come on suddenly, without any forerunners. Therefore, parents should always be ready to provide first aid to the child.

In no case do not try to bring the child to his senses, the seizure cannot be stopped. Better not let it fall in time and remove all sharp objects. If the spasms are frequent, be sure to carry a spoon that can be placed between the teeth to prevent the child from swallowing the tongue.

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(lat. Epilepsia - seized, caught, caught) - one of the most common chronic human neurological diseases, manifested in the body's predisposition to the sudden onset of convulsive seizures. Other common and commonly used names for these sudden attacks are an epileptic seizure, "falling." Epilepsy affects not only people, but also animals, such as dogs, cats, mice. Many great ones, namely Julius Caesar, Napoleon Bonaparte, Peter the Great, Fyodor Dostoyevsky, Alfred Nobel, Joan of Arc, Ivan IV the Terrible, Vincent van Gogh, Winston Churchill, Lewis Carroll, Alexander the Great, Alfred Nobel, Dante Alighieri, Fyodor Dostoyevsky , Nostradamus and others suffered from epilepsy.

This disease was called "God's mark", believing that people with epilepsy are marked from above. The nature of the appearance of this disease has not yet been established, there are several assumptions in medicine, but there is no exact data.

The popular belief that epilepsy is an incurable disease is wrong. The use of modern antiepileptic drugs can completely eliminate seizures in 65% of patients and significantly reduce the number of seizures in another 20%. The basis of treatment is long-term daily drug therapy with regular follow-up studies and medical examinations.

Medicine has established that epilepsy is a hereditary disease, it can be transmitted through the mother's line, but more often it is transmitted through the male line, it may not be transmitted at all or it may manifest itself through a generation. There is a possibility of epilepsy in children conceived by parents in a drunken state or with syphilis. Epilepsy can be an "acquired" disease, as a result of severe fright, head injury, mother's illness during pregnancy, due to the formation of brain tumors, cerebrovascular malformations, birth injuries, infections of the nervous system, poisoning, neurosurgical operations.

An epileptic seizure occurs as a result of the simultaneous excitation of nerve cells, which occurs in a certain area of ​​​​the cerebral cortex.

Epilepsy is classified into the following types based on its occurrence:

1. symptomatic- it is possible to detect a structural defect of the brain, for example, a cyst, a tumor, a hemorrhage, malformations, a manifestation of organic damage to brain neurons;
2. idiopathic- there is a hereditary predisposition, and there are no structural changes in the brain. The basis of idiopathic epilepsy is channelopathy (genetically determined diffuse instability of neuronal membranes). There are no signs of organic brain damage in this variant of epilepsy; the intelligence of patients is normal;
3. cryptogenic- the cause of the disease cannot be identified.

Before each epileptic seizure, a person experiences a special condition called an aura. The aura manifests differently in each person. It all depends on the location of the epileptogenic focus. The aura can be manifested by fever, anxiety, dizziness, the patient feels cold, pain, numbness of some parts of the body, strong heartbeat, an unpleasant smell, taste of some food, sees a bright flicker. It should be remembered that during an epileptic attack, a person not only is not aware of anything, but also does not experience any pain. An epileptic seizure lasts for several minutes.

Under a microscope, during an epileptic seizure, swelling of cells, small areas of hemorrhages are visible in this place of the brain. Each seizure facilitates the next one by forming permanent seizures. That's why epilepsy needs to be treated! Treatment is strictly individual!

Predisposing factors:

• change in climatic conditions,
• lack or excess of sleep,
• fatigue,
• bright daylight.

Epilepsy symptoms

Manifestations of epileptic seizures vary from generalized convulsions to changes in the patient's internal state that are barely noticeable to others. There are focal seizures associated with the occurrence of an electrical discharge in a certain limited area of ​​​​the cerebral cortex and generalized seizures, in which both hemispheres of the brain are simultaneously involved in the discharge. With focal seizures, convulsions or peculiar sensations (for example, numbness) in certain parts of the body (face, arms, legs, etc.) can be observed. Also, focal seizures can be manifested by short attacks of visual, auditory, olfactory, or gustatory hallucinations. Consciousness during these attacks can be preserved, in which case the patient describes in detail his feelings. Partial or focal seizures are the most common manifestation of epilepsy. They occur when nerve cells are damaged in a specific area of ​​​​one of the hemispheres of the brain and are divided into:

1. simple - with such seizures there is no disturbance of consciousness;
2. complex - seizures with a violation or change in consciousness, are caused by areas of overexcitation that are diverse in localization and often turn into generalized ones;
3. Secondary generalized seizures - characterized by the onset in the form of a convulsive or non-convulsive partial seizure or absence, followed by a bilateral spread of convulsive motor activity to all muscle groups.

The duration of partial seizures is usually no more than 30 seconds.

There are states of the so-called trance - outwardly ordered actions without consciousness control; upon the return of consciousness, the patient cannot remember where he was and what happened to him. A kind of trance is sleepwalking (sometimes not of epileptic origin).

Generalized seizures are convulsive and non-convulsive (absences). For others, the most frightening are generalized convulsive seizures. At the beginning of an attack (tonic phase), there is a tension of all muscles, a short-term cessation of breathing, a piercing cry is often observed, biting of the tongue is possible. After 10-20 sec. the clonic phase begins, when muscle contractions alternate with their relaxation. Urinary incontinence is often observed at the end of the clonic phase. Seizures usually stop spontaneously after a few minutes (2-5 minutes). Then comes the post-attack period, characterized by drowsiness, confusion, headache and the onset of sleep.

Non-convulsive generalized seizures are called absences. They occur almost exclusively in childhood and early adolescence. The child suddenly freezes and gazes intently at one point, the look seems to be absent. Covering the eyes, trembling of the eyelids, slight tilting of the head can be observed. Attacks last only a few seconds (5-20 seconds) and often go unnoticed.

The occurrence of an epileptic seizure depends on a combination of two factors of the brain itself: the activity of the convulsive focus (sometimes also called epileptic) and the general convulsive readiness of the brain. Sometimes an epileptic seizure is preceded by an aura (a Greek word meaning "breeze", "breeze"). The manifestations of the aura are very diverse and depend on the location of the part of the brain whose function is impaired (that is, on the localization of the epileptic focus). Also, certain conditions of the body can be a provoking factor for an epileptic seizure (epileptic seizures associated with the onset of menstruation; epileptic seizures that occur only during sleep). In addition, an epileptic seizure can be provoked by a number of environmental factors (for example, flickering light). There are a number of classifications of characteristic epileptic seizures. From the point of view of treatment, the classification based on the symptoms of seizures is most convenient. It also helps to distinguish epilepsy from other paroxysmal conditions.

Types of epileptic seizures

What are the types of seizures?

Epileptic seizures are very diverse in their manifestations - from severe general convulsions to an imperceptible blackout. There are also such as: a feeling of a change in the shape of surrounding objects, twitching of the eyelid, tingling in the finger, discomfort in the stomach, short-term inability to speak, leaving home for many days (trances), rotation around its axis, etc.

More than 30 types of epileptic seizures are known. Currently, the International Classification of Epilepsy and Epileptic Syndromes is used to systematize them. This classification distinguishes two main types of seizures - generalized (general) and partial (focal, focal). They, in turn, are divided into subtypes: tonic-clonic seizures, absences, simple and complex partial seizures, as well as other seizures.

What is an aura?

Aura (a Greek word meaning "breeze", "breeze") is the state that precedes an epileptic seizure. The manifestations of the aura are very diverse and depend on the location of the part of the brain whose function is impaired. They can be: fever, anxiety and restlessness, sound, strange taste, smell, change in visual perception, unpleasant sensations in the stomach, dizziness, "already seen" (deja vu) or "never seen" (jamais vu) states , a feeling of inner bliss or longing, and other sensations. The ability of a person to correctly describe his aura can be of great help in diagnosing the localization of changes in the brain. The aura can also be not only a harbinger, but also an independent manifestation of a partial epileptic seizure.

What are generalized seizures?

Generalized seizures are seizures in which paroxysmal electrical activity covers both hemispheres of the brain. And additional brain studies in such cases do not reveal focal changes. The main generalized seizures include tonic-clonic (generalized convulsive seizures) and absences (short-term blackouts). Generalized seizures occur in about 40% of people with epilepsy.

What are tonic-clonic seizures?

Generalized tonic-clonic seizures (grand mal) are characterized by the following manifestations:

1. turning off consciousness;
2. tension of the trunk and limbs (tonic convulsions);
3. twitching of the trunk and limbs (clonic convulsions).

During such an attack, breathing may be held for a while, but this never leads to suffocation of a person. Usually the attack lasts 1-5 minutes. After an attack, sleep, a state of stupor, lethargy, and sometimes a headache may occur.

In the event that an aura or a focal attack occurs before an attack, it is regarded as partial with secondary generalization.

What are absences (fading)?

Absences (petite mal) are generalized seizures with a sudden and short-term (from 1 to 30 seconds) loss of consciousness, not accompanied by convulsive manifestations. The frequency of absences can be very high, up to several hundred seizures per day. They are often not noticed, believing that the person was thinking at that time. During an absence, movements suddenly stop, the gaze stops, and there is no reaction to external stimuli. Aura never happens. Sometimes there may be eye rolling, twitching of the eyelids, stereotyped movements of the face and hands, and discoloration of the skin of the face. After the attack, the interrupted action resumes.

Absences are characteristic of childhood and adolescence. Over time, they can transform into other types of seizures.

What is juvenile myoclonic epilepsy?

Adolescent myoclonic epilepsy begins between the onset of puberty (puberty) and 20 years of age. It is manifested by lightning-fast twitches (myoclonus), as a rule, of the hands while maintaining consciousness, sometimes accompanied by generalized tonic or tonic-clonic seizures. These attacks mostly occur within 1-2 hours before or after awakening from sleep. The electroencephalogram (EEG) often shows characteristic changes, and there may be an increased sensitivity to light flicker (photosensitivity). This form of epilepsy responds well to treatment.

What are partial seizures?

Partial (focal, focal) seizures are seizures caused by paroxysmal electrical activity in a limited area of ​​the brain. This type of seizure occurs in about 60% of people with epilepsy. Partial seizures can be simple or complex.

Simple partial seizures are not accompanied by impaired consciousness. They can manifest as twitching or discomfort in certain parts of the body, turning the head, discomfort in the abdomen, and other unusual sensations. Often these attacks are similar to an aura.

Complex partial seizures have more pronounced motor manifestations and are necessarily accompanied by one or another degree of change in consciousness. Previously, these seizures were classified as psychomotor and temporal lobe epilepsy.

In partial seizures, a thorough neurological examination is always performed to rule out underlying brain disease.

What is rolandic epilepsy?

Its full name is "benign childhood epilepsy with central-temporal (rolandic) peaks." Already from the name it follows that it responds well to treatment. Seizures appear in early childhood and stop in adolescence. Rolandic epilepsy usually presents with partial seizures (eg, unilateral twitching of the corner of the mouth with salivation, swallowing) that usually occur during sleep.

What is status epilepticus?

Status epilepticus is a condition where epileptic seizures follow each other without interruption. This condition is life threatening. Even with the current level of development of medicine, the risk of death of the patient is still very high, so a person with status epilepticus must be taken without delay to the intensive care unit of the nearest hospital. Seizures recurring so frequently that between them the patient does not regain consciousness; distinguish epileptic status of focal and generalized seizures; very localized motor seizures are termed "permanent partial epilepsy".

What are pseudo-seizures?

These states are deliberately caused by a person and outwardly look like seizures. They can be staged in order to attract additional attention to themselves or to avoid any activity. It is often difficult to distinguish a true epileptic seizure from a pseudoepileptic one.

Pseudo-epileptic seizures are observed:

• in childhood;
• more often in women than in men;
• in families where there are relatives with mental illness;
• with hysteria;
• in the presence of a conflict situation in the family;
• in the presence of other brain diseases.

Unlike epileptic seizures, pseudo-seizures do not have a characteristic post-seizure phase, a return to normal occurs very quickly, the person smiles often, there is rarely damage to the body, irritability rarely occurs, and more than one attack rarely occurs in a short period of time. Electroencephalography (EEG) can accurately identify pseudoepileptic seizures.

Unfortunately, pseudoepileptic seizures are often mistakenly regarded as epileptic seizures, and patients begin to receive treatment with specific drugs. Relatives in such cases are frightened by the diagnosis, as a result, anxiety is induced in the family and hyper-custody is formed over a pseudo-sick person.

Convulsive focus

A convulsive focus is the result of organic or functional damage to a part of the brain caused by any factor (insufficient blood circulation (ischemia), perinatal complications, head injuries, somatic or infectious diseases, brain tumors and anomalies, metabolic disorders, stroke, toxic effects of various substances). At the site of structural damage, a scar (which sometimes forms a fluid-filled cavity (cyst)). In this place, acute swelling and irritation of the nerve cells of the motor zone can periodically occur, which leads to convulsive contractions of the skeletal muscles, which, in case of generalization of excitation to the entire cerebral cortex, end in loss of consciousness.

Convulsive readiness

Convulsive readiness is the probability of an increase in pathological (epileptiform) excitation in the cerebral cortex above the level (threshold) at which the anticonvulsant system of the brain functions. It can be high or low. With high convulsive readiness, even a small activity in the focus can lead to the appearance of a full-blown convulsive attack. The convulsive readiness of the brain can be so great that it leads to a short-term loss of consciousness even in the absence of a focus of epileptic activity. In this case, we are talking about absences. Conversely, there may be no convulsive readiness at all, and, in this case, even with a very strong focus of epileptic activity, partial seizures occur that are not accompanied by loss of consciousness. The cause of increased convulsive readiness is intrauterine cerebral hypoxia, hypoxia during childbirth or hereditary predisposition (the risk of epilepsy in the offspring of patients with epilepsy is 3-4%, which is 2-4 times higher than in the general population).

Diagnosis of epilepsy

In total, there are about 40 different forms of epilepsy and different types of seizures. At the same time, for each form, its own treatment regimen has been developed. That is why it is so important for a doctor not only to diagnose epilepsy, but also to determine its form.

How is epilepsy diagnosed?

A complete medical examination includes the collection of information about the life of the patient, the development of the disease and, most importantly, a very detailed description of the attacks, as well as the conditions that preceded them, by the patient himself and by eyewitnesses of the attacks. If seizures occur in a child, then the doctor will be interested in the course of pregnancy and childbirth in the mother. Necessarily carried out a general and neurological examination, electroencephalography. Special neurological studies include nuclear magnetic resonance imaging and computed tomography. The main task of the examination is to identify current diseases of the body or brain that could cause seizures.

What is electroencephalography (EEG)?

Using this method, the electrical activity of brain cells is recorded. This is the most important test in the diagnosis of epilepsy. An EEG is performed immediately after the onset of the first seizures. In epilepsy, specific changes (epileptic activity) appear on the EEG in the form of discharges of sharp waves and peaks of higher amplitude than ordinary waves. In generalized seizures, the EEG shows groups of generalized peak-wave complexes in all areas of the brain. With focal epilepsy, changes are detected only in certain, limited areas of the brain. Based on the EEG data, a specialist can determine what changes have occurred in the brain, clarify the type of seizures, and, based on this, determine which drugs will be preferable for treatment. Also, with the help of EEG, the effectiveness of the treatment is monitored (especially important for absences), and the issue of stopping treatment is decided.

How is an EEG performed?

An EEG is a completely harmless and painless test. To conduct it, small electrodes are applied to the head and fixed on it with the help of a rubber helmet. Electrodes are connected by wires to an electroencephalograph, which amplifies the electrical signals of brain cells received from them by 100 thousand times, writes them down on paper or enters readings into a computer. During the examination, the patient lies or sits in a comfortable diagnostic chair, relaxed, with his eyes closed. Usually, when taking an EEG, so-called functional tests (photostimulation and hyperventilation) are carried out, which are provocative loads on the brain through bright light flashing and increased respiratory activity. If an attack begins during the EEG (this is very rare), then the quality of the examination increases significantly, since in this case it is possible to more accurately determine the area of ​​\u200b\u200bdisturbed electrical activity of the brain.

Are EEG changes grounds for the detection or exclusion of epilepsy?

Many EEG changes are nonspecific and provide only supporting information for the epileptologist. Only on the basis of the detected changes in the electrical activity of brain cells, one cannot speak of epilepsy, and, conversely, this diagnosis cannot be ruled out with a normal EEG if epileptic seizures occur. EEG activity is regularly detected in only 20-30% of people with epilepsy.

Interpretation of changes in the bioelectrical activity of the brain is, to some extent, an art. Changes similar to epileptic activity can be caused by eye movement, swallowing, vascular pulsation, respiration, electrode movement, electrostatic discharge, and other causes. In addition, the electroencephalographer must take into account the age of the patient, since the EEG of children and adolescents differs significantly from the electroencephalogram of adults.

What is a hyperventilation test?

This is frequent and deep breathing for 1-3 minutes. Hyperventilation causes pronounced metabolic changes in the substance of the brain due to the intensive removal of carbon dioxide (alkalosis), which, in turn, contribute to the appearance of epileptic activity on the EEG in people with seizures. Hyperventilation during EEG recording allows revealing latent epileptic changes and clarifying the nature of epileptic seizures.

What is photostimulation EEG?

This trial is based on the fact that flashes of light can cause seizures in some people with epilepsy. During the recording of the EEG, a bright light flashes rhythmically (10-20 times per second) in front of the eyes of the patient under study. Detection of epileptic activity during photostimulation (photosensitive epileptic activity) allows the doctor to choose the most correct treatment tactics.

Why is an EEG with sleep deprivation performed?

Sleep deprivation (deprivation) for 24-48 hours before the EEG is performed to detect latent epileptic activity in difficult-to-recognize cases of epilepsy.

Sleep deprivation is a fairly strong trigger for seizures. This test should only be used under the guidance of an experienced physician.

What is an EEG in sleep?

As is known, in certain forms of epilepsy, changes in the EEG are more pronounced, and sometimes only able to be perceptible during a study in a dream. EEG recording during sleep makes it possible to detect epileptic activity in most of those patients in whom it was not detected during the daytime even under the influence of conventional provocative tests. But, unfortunately, such a study requires special conditions and training of medical personnel, which limits the wide application of this method. It is especially difficult to carry it out in children.

Is it right not to take antiepileptic drugs before an EEG?

This should not be done. Abrupt discontinuation of drugs provokes seizures and can even cause status epilepticus.

When is video-EEG used?

This very complex study is carried out in cases where it is difficult to determine the type of epileptic seizure, as well as in the differential diagnosis of pseudo-seizures. A video EEG is a video recording of an attack, often during sleep, with simultaneous EEG recording. This study is carried out only in specialized medical centers.

Why is brain mapping done?

This type of EEG with computer analysis of the electrical activity of brain cells is usually carried out for scientific purposes. The use of this method in epilepsy is limited to detecting only focal changes.

Is EEG harmful to health?

Electroencephalography is an absolutely harmless and painless study. EEG is not associated with any effect on the brain. This study can be done as often as necessary. The EEG only causes a slight inconvenience associated with the wearing of a helmet on the head and slight dizziness, which may occur during hyperventilation.

Do the EEG results depend on the device used for the study?

EEG devices - electroencephalographs, manufactured by various companies, do not fundamentally differ from each other. Their difference is only in the level of technical service for specialists and in the number of registration channels (electrodes used). The EEG results largely depend on the qualifications and experience of the specialist conducting the study and analysis of the data obtained.

How to prepare a child for an EEG?

The child must be explained what awaits him during the study, and convinced of his painlessness. The child before the study should not feel hungry. The head must be clean. With young children, it is necessary to practice on the eve of putting on a helmet and staying still with your eyes closed (you can stage a game of an astronaut or a tanker), as well as teach you to breathe deeply and often under the “inhale” and “exhale” commands.

CT scan

Computed tomography (CT) is a method of examining the brain using radioactive (X-ray) radiation. During the study, a series of images of the brain is taken in different planes, which, unlike conventional radiography, allows you to get an image of the brain in three dimensions. CT allows to detect structural changes in the brain (tumors, calcifications, atrophies, hydrocephalus, cysts, etc.).

However, CT data may not be informative for certain types of seizures, which include, in particular:

any epileptic seizures for a long time, especially in children;

generalized epileptic seizures with no focal EEG changes and no evidence of brain damage on neurological examination.

Magnetic resonance imaging

Magnetic resonance imaging is one of the most accurate methods for diagnosing structural changes in the brain.

Nuclear Magnetic Resonance (NMR)- This is a physical phenomenon based on the properties of some atomic nuclei, when placed in a strong magnetic field, to absorb energy in the radio frequency range and radiate it after the cessation of exposure to the radio frequency pulse. In terms of its diagnostic capabilities, NMR is superior to computed tomography.

The main disadvantages usually include:

1. low reliability of detection of calcifications;
2. high price;
3. the impossibility of examining patients with claustrophobia (fear of closed spaces), artificial pacemakers (pacemaker), large metal implants made of non-medical metals.

Is a medical examination necessary in cases where there are no more seizures?

If a person with epilepsy has stopped seizures, and the drugs have not yet been canceled, then he is recommended to conduct a control general and neurological examination at least once every six months. This is especially important for controlling the side effects of antiepileptic drugs. Usually, the condition of the liver, lymph nodes, gums, hair is checked, as well as laboratory blood tests and liver tests. In addition, sometimes it is necessary to control the amount of anticonvulsants in the blood. Neurological examination at the same time includes a traditional examination by a neurologist and an EEG.

Cause of death in epilepsy

Status epilepticus is especially dangerous due to pronounced muscle activity: tonic-clonic convulsions of the respiratory muscles, inhalation of saliva and blood from the oral cavity, as well as delays and arrhythmias of breathing lead to hypoxia and acidosis. The cardiovascular system is experiencing exorbitant loads due to the gigantic muscular work; hypoxia increases cerebral edema; acidosis enhances hemodynamic and microcirculation disorders; Secondly, the conditions for brain functioning worsen more and more. With prolonged epileptic status in the clinic, the depth of the coma increases, convulsions take on a tonic character, muscle hypotension is replaced by their atony, and hyperreflexia by areflexia. Growing hemodynamic and respiratory disorders. Convulsions can completely stop, and the stage of epileptic prostration sets in: the palpebral fissures and mouth are half open, the gaze is indifferent, the pupils are wide. In this state, death can occur.

Two main mechanisms lead to cytotoxic action and necrosis, in which cellular depolarization is supported by stimulation of NMDA receptors, and the key point is the launch of a destruction cascade inside the cell. In the first case, excessive neuronal excitation is the result of edema (fluid and cations enter the cell), leading to osmotic damage and cell lysis. In the second case, activation of NMDA receptors activates the flow of calcium into the neuron with the accumulation of intracellular calcium to a level higher than the cytoplasmic calcium binding protein can accommodate. Free intracellular calcium is toxic to the neuron and leads to a series of neurochemical reactions, including mitochondrial dysfunction, activates proteolysis and lipolysis, which destroys the cell. This vicious circle underlies the death of a patient with status epilepticus.

Epilepsy prognosis

In most cases, after a single attack, the prognosis is favorable. Approximately 70% of patients undergo remission during treatment, that is, there are no seizures for 5 years. Seizures continue in 20-30%, in such cases, the simultaneous administration of several anticonvulsants is often required.

First aid

Signs or symptoms of an attack are usually: convulsive muscle contractions, respiratory arrest, loss of consciousness. During an attack, others need to remain calm - without showing panic and fuss, provide the correct first aid. These symptoms of an attack should go away on their own within a few minutes. To accelerate the natural cessation of the symptoms that accompany an attack, others most often cannot.

The most important goal of first aid during an attack is to prevent harm to the health of the person who has an attack.

The onset of an attack may be accompanied by loss of consciousness and a person falling to the floor. When falling from the stairs, next to objects that stand out from the floor level, bruises of the head and fractures are possible.

Remember: an attack is not a disease transmitted from one person to another, act boldly and correctly, providing first aid.

Getting into an attack

Support the falling person with your hands, lower him here on the floor or seat him on a bench. If a person is in a dangerous place, for example, at a crossroads or near a cliff, raising his head, taking him under the armpits, move him a little away from the dangerous place.

The beginning of the attack

Sit next to the person and hold the most important thing - the head of the person, it is most convenient to do this by holding the head of the person lying between your knees and holding it from above with your hands. The limbs can not be fixed, they will not make amplitude movements, and if initially a person lies comfortably enough, then he will not be able to inflict injuries on himself. Other people are not required nearby, ask them to move away. The main phase of the attack. While holding your head, prepare a folded handkerchief or part of the person's clothing. This may be required to wipe saliva, and if the mouth is open, then a piece of this matter, folded in several layers, can be inserted between the teeth, this will prevent biting the tongue, cheeks, or even damage to the teeth against each other during cramps.

If the jaws are tightly closed, do not try to open the mouth by force (this most likely will not work and may injure the oral cavity).

With increased salivation, continue to hold the person's head, but turn it to the side so that saliva can drain to the floor through the corner of the mouth and does not enter the respiratory tract. It's okay if a little saliva gets on your clothes or hands.

Exit from attack

Remain completely calm, an attack with respiratory arrest can last several minutes, memorize the sequence of symptoms of an attack in order to describe them to the doctor later.

After the convulsions end and the body relaxes, it is necessary to put the victim in a recovery position - on his side, this is necessary to prevent the root of the tongue from sinking.

The victim may have medicines, but they can be used only at the direct request of the victim, otherwise criminal liability for causing harm to health may follow. In the vast majority of cases, the exit from the attack should occur naturally, and the right medicine or mixture of them and the dose will be selected by the person himself after leaving the attack. Searching a person in search of instructions and medicines is not worth it, as this is not necessary, but will only cause an unhealthy reaction from others.

In rare cases, the exit from the attack may be accompanied by involuntary urination, while the person still has convulsions at this time, and consciousness has not fully returned to him. Politely ask other people to move away and disperse, hold the person's head and shoulders and gently prevent him from getting up. Later, a person will be able to cover himself, for example, with an opaque bag.

Sometimes at the exit from an attack, even with rare convulsions, a person tries to get up and start walking. If you can keep spontaneous impulses from side to side of the person, and the place is not dangerous, for example, in the form of a road nearby, a cliff, etc., let the person, without any help from you, get up and walk with him, holding him tightly. If the place is dangerous, then until the complete cessation of convulsions or the complete return of consciousness, do not allow him to get up.

Usually 10 minutes after the attack, the person completely returns to his normal state and he no longer needs first aid. Let the person make the decision on the need to seek medical help; after recovering from an attack, this is sometimes no longer necessary. There are people who have seizures several times a day, and at the same time they are completely full members of society.

Often, young people are uncomfortable with the attention of other people to this incident, and much more than the attack itself. Cases of an attack under certain irritants and external circumstances can occur in almost half of the patients; modern medicine does not allow for preliminary insurance against this.

A person whose attack is already ending should not be made the focus of general attention, even if the person emits involuntary convulsive cries when exiting the attack. You could, holding the person's head, for example, talk calmly to the person, this helps to reduce stress, gives confidence to the person coming out of an attack, and also calms onlookers and encourages them to disperse.

An ambulance should be called in case of a repeated attack, the onset of which indicates an exacerbation of the disease and the need for hospitalization, since further attacks may follow a second attack in a row. When communicating with the operator, it is enough to indicate the gender and approximate age of the victim, to the question “What happened?” answer “a repeated attack of epilepsy”, name the address and large fixed landmarks, at the request of the operator, provide information about yourself.

In addition, an ambulance should be called if:

• seizure lasts more than 3 minutes
• after an attack, the victim does not regain consciousness for more than 10 minutes
• attack occurred for the first time
• the seizure occurred in a child or an elderly person
• a seizure occurred in a pregnant woman
• during the attack, the victim was injured.

Epilepsy treatment

Treatment of a patient with epilepsy is aimed at eliminating the cause of the disease, suppressing the mechanisms of seizure development and correcting the psychosocial consequences that may occur as a result of the neurological dysfunction underlying the diseases or in connection with a persistent decrease in working capacity.

If the epileptic syndrome is the result of metabolic disorders, such as hypoglycemia or hypocalcemia, then after the restoration of metabolic processes to a normal level, the seizures usually stop. If epileptic seizures are caused by an anatomical lesion of the brain, such as a tumor, an arteriovenous malformation, or a brain cyst, then removal of the pathological focus also leads to the disappearance of seizures. However, long-term even non-progressive lesions can cause the development of various negative changes. These changes can lead to the formation of chronic epileptic foci that cannot be eliminated by removing the primary lesion. In such cases, control is needed, sometimes surgical extirpation of the epileptic areas of the brain is necessary.

Medical treatment of epilepsy

• Anticonvulsants, another name for anticonvulsants, reduce the frequency, duration, and in some cases completely prevent seizures:
• Neurotropic drugs - can inhibit or stimulate the transmission of nervous excitation in various parts of the (central) nervous system.
• Psychoactive substances and psychotropic drugs affect the functioning of the central nervous system, leading to a change in mental state.
• Racetams are a promising subclass of psychoactive nootropics.

Antiepileptic drugs are chosen depending on the form of epilepsy and the nature of the seizures. The drug is usually prescribed in a small initial dose with a gradual increase until the optimal clinical effect appears. If the drug is ineffective, it is gradually canceled and the next one is prescribed. Remember that under no circumstances should you independently change the dosage of the medicine or stop treatment. A sudden change in dose can provoke a deterioration in the condition and an increase in seizures.

Non-drug treatments

• Surgery;
• Voight method;
• osteopathic treatment;
• The study of the influence of external stimuli that affect the frequency of attacks, and the weakening of their influence. For example, the frequency of seizures may be influenced by the daily regimen, or it may be possible to individually establish a connection, for example, when wine is consumed, and then it is washed down with coffee, but this is all individual for each organism of a patient with epilepsy;
• Ketogenic diet.

Epilepsy and driving

Each state has its own rules for determining when a person with epilepsy can obtain a driver's license, and several countries have laws requiring physicians to report epilepsy patients to the registry and inform patients of their responsibility for doing so. In general, patients can drive a car if within 6 months - 2 years (with or without drug treatment) they have not had seizures. In some countries, the exact duration of this period is not defined, but the patient must obtain a doctor's opinion that the seizures have stopped. The doctor is obliged to warn the patient with epilepsy about the risks that he is exposed to while driving with such a disease.

Most patients with epilepsy, with adequate seizure control, attend school, go to work, and lead a relatively normal life. Children with epilepsy usually have more problems at school than their peers, but every effort should be made to enable these children to learn normally by providing them with extra help in the form of tutoring and psychological counseling.

How is epilepsy related to sex life?

Sexual behavior is an important but very private part of life for most men and women. Studies have shown that about a third of people with epilepsy, regardless of gender, have sexual problems. The main causes of sexual disorders are psychosocial and physiological factors.

Psychosocial factors:

• limited social activity;
• lack of self-esteem;
• rejection by one of the partners of the fact that the other has epilepsy.

Psychosocial factors invariably cause sexual dysfunction in various chronic diseases, and are also the cause of sexual problems in epilepsy. The presence of seizures often leads to a feeling of vulnerability, helplessness, inferiority and interferes with the establishment of a normal relationship with a sexual partner. In addition, many fear that their sexual activity may trigger seizures, especially when the seizures are triggered by hyperventilation or physical activity.

Even such forms of epilepsy are known, when sexual sensations act as a component of an epileptic seizure and, as a result, form a negative attitude towards any manifestations of sexual desires.

Physiological factors:

• dysfunction of brain structures responsible for sexual behavior (deep structures of the brain, temporal lobe);
• hormonal changes due to seizures;
• increase in the level of inhibitory substances in the brain;
• a decrease in the level of sex hormones due to the use of drugs.

A decrease in sexual desire is observed in about 10% of people receiving antiepileptic drugs, and to a greater extent it is expressed in those taking barbiturates. A rather rare case of epilepsy is increased sexual activity, which is no less a serious problem.

When evaluating sexual disorders, it must be taken into account that they can also be the result of improper upbringing, religious restrictions and negative experiences of early sexual life, but the most common cause is a violation of relationships with a sexual partner.

epilepsy and pregnancy

Most women with epilepsy are able to carry an uncomplicated pregnancy and give birth to healthy children, even if they are taking anticonvulsants at this time. However, during pregnancy, the course of metabolic processes in the body changes, special attention should be paid to the levels of antiepileptic drugs in the blood. Sometimes relatively high doses have to be administered to maintain therapeutic concentrations. The majority of sick women, whose condition was well controlled before pregnancy, continue to feel satisfactory during pregnancy and childbirth. Women who fail to control seizures before pregnancy are at higher risk of developing complications during pregnancy.

One of the most serious complications of pregnancy, morning sickness, often presents with generalized tonic-clonic seizures in the last trimester. Such seizures are a symptom of a severe neurological disorder and are not a manifestation of epilepsy, occurring in women with epilepsy no more often than in others. Toxicosis must be corrected: this will help prevent the occurrence of seizures.

In the offspring of women with epilepsy, the risk of embryonic malformations is 2-3 times higher; apparently, this is due to a combination of low frequency of drug-induced malformations and genetic predisposition. Congenital malformations observed include fetal hydantoin syndrome, characterized by cleft lip and palate, heart defects, finger hypoplasia, and nail dysplasia.

The ideal for a woman planning a pregnancy would be to stop taking antiepileptic drugs, but it is very likely that in a large number of patients this will lead to a recurrence of seizures, which will later be more detrimental to both mother and child. If the condition of the patient allows to cancel the treatment, then this can be done at a suitable time before the onset of pregnancy. In other cases, it is desirable to carry out maintenance treatment with one drug, prescribing it at the minimum effective dose.

Children exposed to chronic intrauterine exposure to barbiturates often have transient lethargy, hypotension, restlessness, and often signs of barbiturate withdrawal. These children should be included in the risk group for the occurrence of various disorders in the neonatal period, slowly removed from the state of dependence on barbiturates and carefully monitored for their development.

There are also seizures that look like epileptic seizures, but are not. Increased excitability in rickets, neurosis, hysteria, disorders of the heart, breathing can cause such attacks.

Affectively - respiratory attacks:

The child begins to cry and at the height of crying stops breathing, sometimes it even goes limp, falls unconscious, there may be twitches. Help with affective seizures is very simple. You need to take as much air as possible into your lungs and blow on the child's face with all your might, or wipe his face with cold water. Reflexively, breathing will be restored, the attack will stop. There is also yactation, when a very small child sways from side to side, it seems that he is rocking himself before going to bed. And who already knows how to sit, sways back and forth. Most often, yactation occurs if there is no necessary spiritual contact (it happens in children in orphanages), rarely - due to mental disorders.

In addition to the listed conditions, there are attacks of loss of consciousness associated with a violation of the activity of the heart, breathing, etc.

Influence on character

Pathological excitation of the cerebral cortex and seizures do not pass without a trace. As a result, the psyche of the patient with epilepsy changes. Of course, the degree of change in the psyche largely depends on the personality of the patient, the duration and severity of the disease. Basically, there is a slowdown in mental processes, primarily thinking and affects. With the course of the disease, changes in thinking progress, the patient often cannot separate the main from the secondary. Thinking becomes unproductive, has a concrete descriptive, stereotyped character; standard expressions predominate in speech. Many researchers characterize it as "labyrinth thinking".

According to the observations, according to the frequency of occurrence among patients, character changes in epileptics can be arranged in the following order:

• slowness,
• viscosity of thinking,
• heaviness,
• short temper,
• selfishness,
• rancor,
• thoroughness,
• hypochondria,
• quarrelsomeness,
• accuracy and pedantry.

The appearance of a patient with epilepsy is characteristic. Slowness, restraint in gestures, reticence, lethargy of facial expressions, inexpressiveness of the face are striking, you can often notice the "steel" gleam of the eyes (a symptom of Chizh).

Malignant forms of epilepsy eventually lead to epileptic dementia. In patients, dementia is manifested by lethargy, passivity, indifference, humility with the disease. Viscous thinking is unproductive, memory is reduced, vocabulary is poor. The affect of tension is lost, but obsequiousness, flattery, hypocrisy remain. In the outcome, indifference to everything except one's own health develops, petty interests, egocentrism. Therefore, it is important to recognize the disease in time! Public understanding and comprehensive support are extremely important!

Can I drink alcohol?

Some people with epilepsy choose not to drink alcohol at all. It is well known that alcohol can provoke seizures, but this is largely due to the individual susceptibility of the person, as well as the form of epilepsy. If a person with seizures is fully adapted to a full life in society, then he will be able to find for himself a reasonable solution to the problem of drinking alcohol. Permissible doses of alcohol per day are for men - 2 glasses of wine, for women - 1 glass.

Can I smoke?

Smoking is bad, it's common knowledge. There was no direct relationship between smoking and seizures. But there is a risk of fire if a seizure occurs while smoking unattended. Women with epilepsy should not smoke during pregnancy, so as not to increase the risk (and already quite high) of malformations in the child.

Important! Treatment is carried out only under the supervision of a physician. Self-diagnosis and self-treatment are unacceptable!

What causes clonic seizures? How to treat them?

Almost every person has experienced a cramp - a phenomenon of spontaneous muscle contraction, accompanied by quite noticeable pain. Spasms of this kind are usually classified into two equivalent classes - convulsions of tonic and clonic type.

Causes of the development of clonic convulsions

The development of convulsions, as a rule, originates in the presence of impaired functionality of the central nervous system. The occurrence of clonic convulsions can be expected in the following conditions of the patient:

• aggravated or transferred hysteria;
• ailments of a neurological nature in the form of acute circulatory disorders of the brain, neuroinfections of an acute / chronic nature, epilepsy, craniocerebral injuries, the presence of volumetric processes in the brain, a hypertensive crisis;
• diseases of an infectious nature in the form of tetanus, childhood infections accompanied by high fever, rabies;
• in violation of the exchange of water-salt as a result of eclampsia, heat stroke;
• in the processes of toxic etiology in the form of renal failure, hypoglycemic coma, adrenal insufficiency, uremia, intoxication.

What is the difference between clonic and tonic

Muscle contraction of an involuntary nature occurs when the body reacts to any of the influences that harm it. However, such spasm does not always occur in the same way.

When muscle contraction is slow and does not bother you for long, this phenomenon is called a tonic cramp, but the clonic cramp will change quite quickly during its development, bringing relaxation to the muscle, then straining it.

With tonic convulsions, the facial and cervical zones can be affected, as well as the entire trunk, including the upper and lower limbs. The patient during such a cramp can clench his teeth and stretch, as well as lose consciousness.

The development of clonic convulsions is smooth and rhythmic in nature, spasmodic muscle contractions in many cases, localized in the limbs. Also, clonic contractions can be of a general nature. With the involvement of the reduced muscles of the respiratory tract in the process, the likelihood of developing stuttering is high.

Symptoms of the phenomenon

The symptomatology of the convulsive syndrome is rapidly changing contractions and relaxation of the muscles. Such an attack, as a rule, provokes pathology in the central nervous system or peripheral nervous system, less often in the muscle tissue itself.

When a cramp comes from the “center”, it is able to involve the muscles of a large area of ​​​​the body in the process of contraction.

The disease involving tonic-clonic convulsive spasm begins to manifest itself from childhood, gradually growing and forcing the patient to suffer from seizures more and more often and more painfully.

At first, the development of epileptic seizures worries the patient no more than twice a year, with a gradual increase in adulthood up to two times in one week.

The convulsive attack develops on the rise. At first, these are twitches of small amplitude, mainly in the area of ​​\u200b\u200bthe limbs. Then the convulsive syndrome already develops into a general epileptic seizure.

With the appearance of foam with blood inclusions from the mouth, the frequency of convulsive spasm decreases, the muscles become relaxed.

At this stage, the patient may completely stop responding to any stimulus.

The process of development of a clonic convulsive seizure undergoes several symptomatic phases:

• the patient involuntarily takes a deep breath;
• upper and lower limbs tremble;
• the frequency of convulsions increases sharply;
• generalized clonic convulsions develop, followed by repetition between long pauses;
• the clonic phase is accompanied by an abundant flow of saliva, in which the patient can often bite his buccal mucosa / tongue;
• it is possible that the tongue will sink, interfering with the functionality of the respiratory tract;
• sweating increases;
• clonic spasm after a minute of activity begins to decline, muscle twitching fades;
• the muscles come into a state of atony, which in turn relaxes the sphincter and forces the patient to urinate involuntarily;
• the duration of the seizure is not more than 180 seconds.

The consciousness of the patient affected by the seizure gradually returns from the stupor. However, a feeling of weakness and deepest weakness does not leave him for a long time, and he is also overcome by drowsiness. In the memory of the just experienced seizure, the patient is not fixed. He is deeply and permanently immersed in sleep.

Possible consequences of this condition include:

• the occurrence of paresis / paralysis;
• mental disorder;
• psychomotor agitation.

First aid

The provision of emergency assistance in such cases should be immediate. Before the paramedics arrive, the following steps must be taken:

• try to lay the patient on the floor and remove all surrounding objects;
• provide fresh air;
• in case of loss of consciousness, fix the position, lying on your side;
• free from excess clothing and other wardrobe items;
• check the oral cavity and, if necessary, free from food waste and vomit;
• control the state of the tongue, preventing it from sinking;
• gently but firmly hold the patient's limbs without allowing him to make sudden movements in order to avoid unconscious injury;
• to exclude directly during the course of the convulsive syndrome the giving to the patient of medicines or drinks.

The danger of a convulsive phenomenon should not be discounted, therefore, immediate assistance is necessary for the victim.

Delay in the elimination of convulsions is fraught with:

• injury and even death for those who drive a car, work at height or associated with heavy lifting and other hazardous activities;
• stopping the blood supply in the zone of convulsions, with prolonged oxygen starvation of the tissue, up to its death.

Those who are prone to seizures will not be out of place, in the conduct of their activities, always have options for resolving the situation at the ready.

First aid for seizures

When the seizure is left behind and the patient comes to his senses, he should be shown to a specialist for diagnostic clarification and selection of an individual treatment program.

Febrile convulsions

sudden seizures

Myoclonic convulsions

Death cramps

Frequent seizures

Source: http://krampf.ru/sudorogi/220-klonicheskie-sudorogi

What are the dangers of clonic and tonic seizures?

Cramps are involuntary and sudden acts of muscle contraction that are accompanied by painful sensations. They arise as a result of exposure to adverse external factors or against the background of a violation of the activity of internal organs. Muscle spasms are usually classified according to their characteristic features.

Clonic convulsions are manifested in the form of alternating acts of muscle tension and relaxation. The main reason for their occurrence is organic lesions of the nervous system. All types of seizures are characterized by paroxysmal conditions. Spasms come and go suddenly, and the duration of seizures varies from a few seconds to several minutes.

Seizure differences

If a person is often tormented by convulsions, then this may indicate the presence of any pathologies that are dangerous to health and require medical attention. To conduct the most correct treatment course, it is necessary to know about the features of different types of seizures and the differences between them. Classification of muscle spasms:

• clonic (rhythmic tension and muscle relaxation);
• tonic convulsions (short-term and severe muscle spasm);
• with clonic-tonic convulsions, which are mixed in nature and usually occur against the background of epilepsy, the patient loses consciousness.

The difference between tonic and clonic seizures lies not only in the nature of their manifestation, but also in the causes of occurrence.

In the first case, muscle contractions appear due to excessive motor activity, overstrain, and they usually affect the lower limbs, as well as the hands, respiratory system or face (less often).

As for clonic spasms, their main causes are a violation of the activity of the cerebral cortex, failures in the transmission of nerve impulses in muscle tissue.

Other causes of seizures:

• severe disorders of the nervous system, such as epilepsy;
• infectious lesions of the body;
• hypertensive crisis;
• intoxication of the body;
• nervous tension;
• vascular pathology;
• violations of water-salt metabolism;
• circulatory disorders;
• traumatic brain injury.

Characteristic symptoms

Tonic seizures usually occur in the upper and lower extremities, in more rare cases they affect the face, back, neck, or other parts of the trunk.

The development of a spasm of the respiratory tract is not excluded. With such convulsions, the affected muscle becomes tense and firm, embossed.

A striking example of a tonic cramp is spasm of the calf muscle, accompanied by severe pain.

With epilepsy and other disorders of the nervous system, generalized tonic seizures are observed, which are characterized by the simultaneous tension of all the muscles of the body.

During a seizure, the body of the victim stretches or assumes an arcuate position, the person begins to clasp his face with his hands, as if trying to protect himself from external influences. Breathing quickens, blood pressure rises, loss of consciousness is possible.

Then comes relaxation, after which many patients experience involuntary acts of urination or defecation.

As for clonic convulsions, then rhythmic, intermittent muscle contraction occurs, the spine bends, and the limbs are bent. Symptomatic phases in clonic convulsions:

1. Involuntary and deep breath.
2. Increasing trembling in limbs.
3. Lack of protective reflexes and reactions to external stimuli.
4. Convulsions.
5. Copious flow of saliva and foam from the mouth.
6. Dropping of the tongue and impaired respiratory function.
7. Profuse perspiration.
8. Subsidence of convulsions, extinction of muscle twitching.
9. Relaxation of all muscles, unconscious urination.

After such an attack, the patient, as a rule, does not remember about it, but feels weak, tired and drowsy, becomes disoriented.

First aid

Seizures of a generalized form can carry a threat to a person's life, so it is extremely important to know how to relieve an attack and provide first aid before the ambulance arrives. You need to do the following:

1. Lay the patient on a soft surface to prevent injury from involuntary movements.
2. If a person is unconscious, then he should lie on his side to prevent suffocation, since vomiting is not ruled out.
3. Open windows and free the victim's chest from tight clothing for fresh air.
4. Monitor the patient's oral cavity, if necessary, release it from vomit, make sure that the tongue does not burn.
5. Hold the limbs of a person during convulsions so that they do not get injured.
6. Do not leave the patient until the arrival of doctors.

It is impossible to provide medical assistance to the patient on his own. The exception is when the seizure has already passed, and the patient himself knows what medicines he needs to take and in what dosage.

With a local cramp, you can help yourself. If a spasm of the calf muscle occurs, it is recommended to prick the tense area with a needle so that relaxation and pain relief occurs. You can also do self-massage and rub the limb with a warming ointment.

Medical measures

Tonic and clonic seizures are not an independent disease, but they usually indicate the presence of some other pathology.

Therefore, the treatment regimen for each individual patient is selected individually, depending on the provoking factors. Preliminary diagnostics is carried out to identify the causes of the convulsive syndrome.

For the relief of seizures, basic drugs are used:

1. Sedatives, tranquilizers (Andaxin, Phenazepam, Trioxazine, Diazepam).
2. Phenobarbital, Thiopental and other barbiturates.
3. Anticonvulsants such as carbamazepine.

Given that the lack of trace elements and minerals often causes seizures, the patient is prescribed a special correct diet, with which it is possible to restore the balance of vitamins and nutrients.

Possible Complications

The consequences of a seizure can be very different. It all depends on which muscles were affected. There is a high probability of death with muscle spasms of the lungs or heart. Other complications:

• impaired respiratory function can cause the development of stuttering or pulmonary edema;
• if during a seizure the patient sharply arches his back, then the risk of a fracture of the spine increases;
• with spasm of the heart muscles, cardiac arrest is possible;
• likely mental disorders;
• sudden movements of the arms and legs often result in serious injuries to the limbs;
• other consequences of sudden movements of the body are tearing of muscle tissue, craniocerebral injuries;
• the development of paralysis or paresis is not excluded;
• stopping the blood supply to the spasmodic area, which can lead to tissue death;
• in case of failures in the circulatory system, hemorrhage in the brain is possible.

It is very important to timely contact a specialist for clonic and tonic convulsions. Compliance with all medical recommendations will help to exclude the recurrence of seizures and complications after them.

Source: https://OrtoCure.ru/svyazki-i-myshtsy/klonicheskie-sudorogi.html

Clonic, tonic and myoclonic seizures: characteristics and differences

Cramps - uncontrolled contraction of muscle tissue due to overexertion; the nature of seizures is paroxysmal.
Typically, seizures are not permanent. Their appearance and disappearance is sudden, but the duration is not more than a minute.

Depending on the cause, seizures can be frequent or infrequent, short or long. Pain is usually not characteristic, but children and the elderly can quite clearly feel muscle contractions, which are manifested by pain syndromes.

The most common time for seizures to occur is at night. This is due to the fact that during sleep all the muscles are in a relaxed state. Also, convulsions are not uncommon in healthy people after an active muscle load.

Seizures are not clearly localized. Muscle contraction can affect both one muscle and the whole group. The most common muscle groups are: calf, thigh, abdomen, back and neck.

convulsive attack

A convulsive attack (syndrome), or in other words an attack of violent movements, which is manifested by a rather strong uncontrolled muscle contraction.

The cause of convulsive seizures in most cases is a violation of calcium metabolism. An important feature of a convulsive attack is that the patient is constantly conscious, even though spastic pains can reach high rates.

The development of an attack can be undulating or single. The duration can also vary greatly. Pain syndrome depends on the disease and the individual characteristics of the person.

With mild convulsions, a slight tingling in the muscles is usually felt - muscle cramps that are located near the spine and large arteries are very dangerous. Pain will be felt not only at the site of the spasm, but throughout the entire length of the nerve or vessel.

In the chronic course of convulsive seizures, brittle nails and bones, hair loss are observed. This is due to calcium leaching. This pathological process worsens the condition of tooth enamel, contributes to the development of conjunctivitis and the progression of cataracts.

All convulsions are characterized by involuntary contraction of muscle fibers and unpleasant pain sensations. However, despite the similarity of symptoms, there is a difference.

Any convulsions and seizures occur due to the negative effect of certain factors, most often the internal environment. Despite the fact that the movement itself during seizures is generalized, only a small part of the muscle groups spasms.

tonic convulsions

Tonic seizures are characterized by:

• short-term reduction process;
• the increase in the peak of spasm occurs gradually;
• causing muscle tension.

The most common localization is the region of the arms and legs. Areas of the abdomen, face, and neck may also be subject to spasm. A rarer localization is the muscles of the respiratory tract.

Extension processes predominate, so the lower and upper limbs are in an open state. The head is thrown back, the teeth are closed, the whole body is stretched due to muscle tension. Possible loss of consciousness.

Clonic convulsions

Characteristic signs of clonic convulsions:

• periods of contraction are replaced by periods of muscle relaxation;
• characteristic twitches of body parts appear;
• self-determination of this type of seizures is not difficult.

The location is the same as in tonic convulsions.

Typical position during an attack

The upper and lower limbs are bent, the spine is arched. With the naked eye, a calm twitching of spasmodic muscles is noticeable. The features include stuttering, which occurs due to spasm of the muscles of the respiratory system.

Tonic-clonic spasms

They combine both the mechanisms of tonic and clonic seizures. There are three stages of development that end in fainting or coma.

The first stage is tonic spasms, which are characteristic:

• pupil dilation;
• eye rolling;
• tension in all muscles.

The second stage is clonic convulsions, a change in periods of contraction and relaxation.

The third stage is a twilight disorder of consciousness. There may be foaming at the mouth due to biting the tongue and a large amount of saliva.

Atonic seizures

These seizures are classified as epileptic attacks. The main feature is a drop in muscle tone and / or loss of consciousness. Spasm can be either regional (local) or generalized. They are very rare.

There are two types of seizures.

Short atonic

The period of decreased muscle tone is very short and affects either the muscles of the neck and head, or the muscles of the lower extremities.

Prolonged

Sudden loss of consciousness and loss of muscle tone lasts for several minutes. After falling to the ground, the patient is unable to speak or move. Due to a sudden fall, severe bruises and fractures often occur.

Partial atonic seizures:

1. Drop attacks, or otherwise bouts of falling. Occur due to epileptic seizures, or due to symmetrical or asymmetrical rigidity.
2. focal atonic seizures. It is characterized by paresis or paralysis of one or more parts of the body.
3. Negative myoclonus.

Focal and generalized seizures

Focal (partial) seizures are those in which the focus is localized in one part of the brain (focal frontal lobe seizure).

During this seizure, the patient remains conscious. However, if the situation is difficult, then clouding of consciousness, frequent blinking, and constant performance of the same type of actions are possible. Before the attack itself, unusual sensations may occur.

Generalized seizures are most often a pathology of neuronal activity. Provokes loss of consciousness, severe muscle atony or generalized spasm.

Possible following manifestations:

• muscle twitching of symmetrical and asymmetrical limbs;
• one point look
• tension in the muscles of the back, limbs;
• uncoordinated lowering of the head.

Myoclonic seizures - seizures

their peculiarity is that they are painless. One or more muscles spasm. Outwardly, you can notice small twitches.

Most often appear at night or during daytime sleep. Over a minute long. Perhaps the appearance of myelolonal fright, which is provoked by a flash of light, a loud knock, a scream.

The manifestation of myoclonal seizures depends on their type: benign and negative.

In a benign course, there is:

• numbness of the muscles of the head;
• eye tick;
• involuntary contraction of the muscles of the neck, limbs, back.

When negative, there is a slight tremor of the hands in an outstretched position.

Causes of convulsive manifestations

The causes depend on the type of seizure.

Epileptic convulsions and seizures

These seizures are very short-lived and rarely exceed 10 seconds. Their appearance is provoked by external irritating factors, such as flashes of light, impact, eating, and internal - the process of memorization, reading.

focal seizures

They differ from generalized ones in that their approach can be felt by a person. This may be the appearance of a smell, visual images, music.

Focal seizures are divided into:

• sensitive;
• motor;
• fits of laughing or crying;
• reflex;
• secondary generalized.

Generalized

Appear due to symmetrical discharges in the cerebral cortex. Appear suddenly.

Seizures are divided into:

• tonic-clonic;
• tonic;
• clonic;
• atypical;
• myoclonus;
• reflex generalized.

Seizures in other neurological diseases

Neurological diseases that provoke the development of convulsive syndrome:

Seizures in other diseases and conditions

Diseases that provoke the development of seizures:

• deficiency of calcium or magnesium;
• insufficient maturity of the brain (in children);
• psychophysiological disorders;
• varicose veins;
• thyroid disease;
• poisoning with nitrogenous decay products;
• cirrhosis;
• diabetes;
• kidney disease;
• atherosclerotic vascular lesions;
• malignant neoplasms;
• pathology of the musculoskeletal system.

Provocative conditions:

• insufficient blood supply to the muscles (during physical activity);
• overwork (insufficient blood supply or stress factors);
• pregnancy;
• increased sweating, diarrhea and salt loss;
• monotonous, often repetitive movement in the brush (typing on a computer);
• pregnancy;
• alcohol intoxication;
• insufficient intake of micro and macro elements during starvation and improper diets.

First aid for convulsions and seizures

In case of convulsive seizures, it is necessary:

• put the patient on a flat but soft surface, if necessary, use outerwear, pillows, blankets;
• release a person from fettering clothing, accessories;
• in case of loss of consciousness, put a person on his side so that the tongue does not throw back and does not inhale saliva and vomit;
• limbs should be carefully held, as excessive force can provoke a fracture or dislocation;
• It is forbidden to give the patient medicines or water during an attack.

What to do if your legs cramp:

• use self-massage or ask another person to stretch a spasmodic muscle;
• stretch muscles;
• raise the limb for a rush of blood;
• use warming ointments and compresses;
• take a warm bath.

Help Concept

Any treatment should begin with a diagnosis, only after that a diagnosis is made and a plan for further therapeutic actions is selected.
If convulsions are caused by diseases of organs and systems that are not related to neurology, then the treatment will be directed specifically to this organ.

If the cause is a certain neurological condition, then it is important to apply measures aimed at eliminating or compensating for this condition.

So convulsions in infectious diseases or febrile conditions disappear on their own, but only after the treatment of the underlying disease and without the development of complications.

The general concept of the treatment of convulsive seizures:

1. Purpose sedatives and muscle relaxants, which will help relax the muscles and reduce the activity of the nervous system. Examples of such drugs are Seduxen and Andaxin.
2. Intravenous Droperidol or Sodium Hydroxybutyrate with severe convulsions or seizures.
3. Nootropics to inhibit the transmission of nerve impulses.
4. Proper nutrition. It is prescribed by a doctor on an individual basis, taking into account the characteristics of the patient and concomitant diseases. It is important to fill the deficiency of missing substances (lack of calcium, magnesium, salts, macronutrients).
5. Surgery(for tumors and epilepsy with an identified focus of epileptic excitation).

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Source: http://NeuroDoc.ru/diagnostika/simptomy/klonicheskie-tonicheskie-sudorogi.html

What is the difference between clonic seizures and other types of muscle spasms

The difference lies in the duration of the contraction: with tonic, the spasmodic muscle remains in this state for a while, and clonic ones look like twitching of a separate muscle, limb, or like convulsions of the whole body.

In the second type of cramps, movements are the result of alternate relaxation and contraction of muscle fibers.

The combined clonic-tonic variant is often observed during epileptic seizures, when different types of spasms are combined or sequentially replace each other.

general characteristics

Clonic or tonic convulsions are the result of involuntary pathological contractions of muscle fibers. The reasons may be different, in most cases we are talking about neurological diseases. Regardless of the etiology, an attack always develops according to the same pattern:

• Due to a violation of neurohumoral regulation or other reasons, the processes of excitation in the activity of the central nervous system begin to prevail over inhibition.
• In a certain area of ​​the brain, a focus is formed that captures a group of neurons and brings them into a state of so-called epileptic readiness.
• Any factor (brain injury, illness, hyperthermia) works as a “trigger”, convulsions occur.

Violation of the work of the skeletal muscles with a tonic cramp is accompanied by their rigidity, limitation or complete inability to move. For example, a spasm of the muscles of the trunk and the back of the head during an epileptic seizure leads to arching of the body in an arc.

Clonic contractions, depending on localization, look like trembling (of the eyelids, chewing muscles), chaotic movements of the limbs, convulsions. Spasm of speech muscles is expressed in stuttering.

If smooth muscles are affected, dysfunction of the internal organs is observed.

Regardless of the type of spasm, it is accompanied by pain sensations of different intensity. Pain in this case is a consequence of infringement of nerve fibers by muscle fibers. In the affected area, the blood supply is also disturbed, therefore, after a seizure, paresthesias - numbness or tingling - may be observed for some time. The pain also persists.

Causes

Clonic and tonic convulsions, as well as their combined variant, are most often manifested in neurological disorders. Up to 80% of diseases of the nervous system are accompanied by muscle spasms, somatic, infectious, endocrine diseases account for no more than 20%. Main reasons:

• organic brain damage, tumors, epilepsy;
• violation of calcium metabolism associated with dysfunction of the kidneys, thyroid gland or insufficient absorption of the trace element;
• intoxication in case of poisoning, late gestosis (eclampsia);
• arterial hypertension with crises of convulsive type or renal pathologies;
• some somatic diseases - heart or liver failure, blood diseases, uremia and others;
• infections (tetanus, cholera);
• hysteria;
• magnesium deficiency, violation of water and electrolyte balance;
• increased physical activity.

Modern diagnostic methods, including instrumental and laboratory ones, allow us to accurately determine the cause of the convulsive syndrome in order to prescribe the appropriate treatment.

Varieties

Tonic and clonic seizures may involve one or more muscle groups.

Localized muscle spasm always has its own name: trismus - a pathological contraction of the masticatory muscles, blepharospasm - the circular muscles of the eye.

Changes in the tone of smooth muscle fibers responsible for the functioning of internal organs are called similarly: cardiospasm, pylorospasm, and others.

If convulsions cover the trunk with limbs, we are talking about a generalized seizure. Spasms can be either one type or combined, tonic-clonic.

The latter variety is characteristic of an epileptic seizure that occurs simultaneously with convulsions of the limbs and tonic tension of the muscles of the body.

A convulsive syndrome of this type is observed not only in epilepsy: febrile convulsions in young children have the same symptoms.

tonic

A spasm of this type occurs suddenly, gradually increasing, then it disappears within a few minutes. A tense muscle has a characteristic convex appearance, firm to the touch.

Tonic convulsions are always accompanied by intense pain sensations, since at this time the nerve fibers are infringed. Any muscle group or some of them individually can be affected.

Most often, the calves and muscles of the hands suffer, and the main causes are micronutrient deficiency, hypothermia, and excessive physical exertion. These localized attacks usually occur at night.

Pathological prolonged contractions of individual muscles can also be observed in the body, head. If several groups are covered, we are talking about generalized convulsions.

For example, during epileptic seizures, the back arches at the same time, the arms tense up, and the jaws clench.

Spasms of smooth muscle fibers of a tonic nature are of great danger: attacks of bronchial asthma or angina pectoris can lead to respiratory arrest, heart attack.

First aid for localized contraction is self-massage, taking a relaxing position. For example, a spasm of the calf muscle is stopped if you pull your toes towards you, and a spasm of the hands is relieved by clenching your fist, shaking.

You can simply hit or prick a spasmodic muscle with a needle. A generalized seizure requires the patient to be kept in the lateral position until the symptoms disappear.

Frequent seizures require consultation with a neurologist and other specialized specialists, as they may indicate serious illnesses.

clonic

The main difference between this type of muscle spasm is the rapid alternation of periods of contraction with relaxation. Clonic convulsions occur for two main reasons: direct damage to the motor neurons of the brain or a disorder in the transmission of nerve impulses to muscle fibers.

As with tonic contractions, one or more muscles may be involved during an attack. Outwardly, the pathology is manifested by tremors, chaotic movements or intense shaking of the whole body (convulsions).

The severity depends on the size of the muscle and the affected area.

With a spasm of one small muscle, so-called tics occur - winking, tilting the head, tremor of the hands. Often, a nervous tic has a psychogenic origin.

Stuttering is another classic example of clonic contractions of the speech muscles. Unlike tonic and tonic-clonic seizures, this variety is not accompanied by pain.

But in time, the attack is usually longer, it can be repeated several times in a row, in series.

A type of clonic myospasm is the so-called hyperkinesis. Hyperkinesia can be expressed in small twitches of individual muscle groups, which is observed when the motor neurons of the brain are damaged.

Such symptoms in the form of a tremor of the head or limbs are characteristic of parkinsonism, neuroses and hysteria. More pronounced motor disorders in the form of intense movements are another type of hyperkinesis.

Tonic-clonic

Combined spasms in neurology are considered the most severe. Attacks of tonic-clonic convulsions are characteristic of epilepsy and can last several minutes.

The classic picture of a generalized epileptic seizure consists of several stages. Initially, there is a tonic spasm, often against the background of loss of consciousness.

In this case, the patient's body arches due to the stiffness of the muscles of the neck and contraction of the muscles of the back. The jaws are usually tightly compressed, the eyes roll back.

At the next stage, clonic tremors of the upper and lower extremities occur, the muscles of the face may be involved in the process. Gradually, a convulsive convulsive seizure covers the whole body, the skin turns pale. With spasm of the respiratory muscles, cyanosis is observed, foam from the mouth may appear.

At the next stage, the attack gradually stops. The intensity of movements decreases, changing into small tremors, slowing down the rhythm of clonic contractions. Quite quickly, complete relaxation of the muscles occurs, which may be accompanied by involuntary emptying of the bladder.

The person regains consciousness, but usually remains disoriented, lethargic, or simply falls asleep. First aid is similar to that for tonic spasms: hold the patient on his side or turn his head to prevent aspiration of vomit by placing an object between the teeth.

Conclusion

Episodic tonic convulsions do not pose a particular health hazard. Rare spasms of the arms or legs are most often caused by active muscular work, static or monotonous loads.

Another common cause is a lack of calcium, magnesium and iron due to an unbalanced diet or pregnancy. In this case, the establishment of a work and rest regime, a revision of the diet and the intake of multivitamin complexes will help get rid of painful attacks.

However, often recurring spasms that cannot be corrected by diet and exercise restriction are a reason to see a doctor.

Clonic and tonic-clonic seizures usually indicate neurological disorders of varying severity. Therefore, in this case, a complete examination and treatment are required.