Epileptic seizures that affect the entire brain are called generalized tonic-clonic seizures, formerly known as grand mal seizures. These seizures can be alarming and potentially dangerous if not treated properly. They include sudden loss of consciousness, muscle rigidity, and jerking movements.
Causes
A variety of causes and risk factors can contribute to generalized tonic-clonic seizures, including:
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The most common cause of generalized tonic-clonic seizures is epilepsy, a neurological disorder characterized by recurrent seizures.
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People with genetic predispositions to epilepsy or certain genetic syndromes are more likely to suffer seizures.
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Traumatic brain injury, stroke, brain tumors, infections, and other structural abnormalities of the brain can cause seizures.
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Low blood sodium levels or low blood glucose levels can trigger seizures.
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The abrupt discontinuation of certain medications, especially anti-seizure medications, can precipitate seizures.
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Sleep deprivation or irregular sleep patterns may trigger seizures.
Symptoms
A generalized tonic-clonic seizure usually consists of two phases:
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A person in the tonic phase loses consciousness suddenly and experiences rigidity in their muscles, falling to the ground and stiffening their limbs.
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Clinical phase is characterized by rhythmic, jerky movements of the limbs and body. The person may also experience frothing at the mouth, tongue biting, or bladder or bowel problems.
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In the postictal phase of a seizure, a person may experience confusion, drowsiness, headaches, muscle soreness, or memory loss.
Diagnosis
To diagnose generalized tonic-clonic seizures, a thorough medical history, physical examination, and various diagnostic tests are required:
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EEGs record the electrical activity of the brain and can identify seizures associated with abnormal patterns.
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To determine if seizures are caused by structural abnormalities or lesions in the brain, an MRI or CT scan may be performed.
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Seizures can be caused by metabolic imbalances, infections, or other underlying medical conditions.
Treatment
Tonic-clonic seizures are typically treated with:
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The most common anti-seizure medications are valproic acid, carbamazepine, phenytoin, and levetiracetam.
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In acute seizures, benzodiazepines such as lorazepam or diazepam can be administered to end prolonged or recurrent seizures.
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By avoiding triggers such as sleep deprivation, stress, alcohol, and illicit drugs, seizures can be reduced.
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People with refractory epilepsy can benefit from VNS therapy by implanting a device that stimulates the vagus nerve.
Prevention
While it may not be possible to prevent all generalized tonic-clonic seizures, certain measures can reduce the risk of seizures and improve seizure control:
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Follow prescribed anti-seizure medications and maintain therapeutic levels of drugs in the blood to prevent seizures.
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Regular sleep schedules and adequate sleep each night can reduce the risk of seizures caused by sleep deprivation.
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Relaxation exercises, mindfulness meditation, or counseling may help some individuals manage stress.
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Limit alcohol consumption and avoid illicit drugs to prevent seizures caused by substance abuse or withdrawal.
