Tonic convulsions: causes and treatment. Emergency care for seizures

Determination of tonic muscle spasms

Tonic cramps are unconscious muscle contractions that appear due to severe and sharp pain. There are three types of seizures: clonic, tonic, and tonic-clonic. To accurately determine the type of seizure in a person, timely diagnosis is necessary. Seizures are not always dangerous, but prompt treatment is necessary. An incorrectly functioning body signals that disturbances are occurring within it. In acute forms of the disease, convulsions are considered a factor in blocking the airways and stopping the heart.

Seizures

When the body undergoes a tonic spasm, an increase in the frequency of spasmodic contractions is noticed.

The difference between tonic convulsions and other types is that parts of the body change their position, blood pressure increases, the reaction to light stimuli decreases, and breathing quickens. Severe forms of the disease can occur with loss of consciousness.

A characteristic feature of a tonic attack is rigidity of the limbs and torso. This process occurs in a short time, so it does not enter the clonic phase. The duration of convulsions is no more than 3 minutes.

The reason for the appearance of tension in the muscles is the improper functioning of the nervous system. It is influenced by improper development of the fetus during pregnancy and the formation of the body in early childhood, genetics and heredity.

Convulsions can occur with a large loss of fluid from the body, an increase in temperature, a lack of oxygen supplied to the brain, or caffeine poisoning.

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 due to 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, the risk of spinal fracture increases;
when the heart muscles spasm, cardiac arrest is possible;
mental disorders are likely;
sudden movements of the arms and legs often result in serious injuries to the limbs;
other consequences of sudden body movements are tearing of muscle tissue, traumatic brain injuries;
the development of paralysis or paresis is possible;
stopping the blood supply to the spasmodic area, which can lead to tissue death;
If there is a disruption in the circulatory system, a cerebral hemorrhage may occur.

It is very important to contact a specialist in a timely manner for clonic and tonic seizures. Compliance with all medical recommendations will help prevent recurrence of attacks and complications after them.

Signs

Medical experts call epilepsy the main disease leading to convulsive syndrome. The approach of a tonic attack can be predicted in advance by several signs: hearing and smell become more acute, and an unpleasant taste appears in the mouth. Epileptics fall into unconsciousness and scream or howl loudly. The muscles experience extreme tension: the jaws tighten, breathing becomes difficult, the face turns blue. The duration of the attack does not exceed 3-5 minutes. After the muscles relax, a sleepy state sets in, and the person is unable to remember what happened.

Types and Symptoms – Epilepsy, Facts

EPILEPSY 101
Causes
Types and symptoms
Diagnosis
Treatment
First aid

The shape, intensity and duration of seizures are related to the number and type of brain cells damaged. There are two main types of seizures: generalized and focal. They range from seizures to brief loss of consciousness.

When both hemispheres (sides) of the brain are involved, the seizures are called “generalized” and affect consciousness and motor function from the very beginning. When only one hemisphere (side) of the brain is involved, the seizures are called “focal” and initially produce specific effects depending on the part of the brain involved. A person can experience both types of seizures.

Types of seizures

GENERALIZED SEIZURES – involving both hemispheres of the brain

Tonic-clonic seizures (formerly known as “grand mal”)

A tonic-clonic seizure is characterized by convulsions in which the person’s body tenses, arms bend, legs, head and neck extend, and the jaw clenches sharply - this is the “tonic” phase. The person falls to the ground, sometimes makes a hoarse cry, and loses consciousness for several minutes. During this time, breathing seems labored or stops, the body twitches, saliva may form in the mouth, and urinary incontinence may occur. This is the “clinical” phase. After some time, the muscle twitching subsides and consciousness returns. A person feels confused and drowsy for some time due to intense muscle work.

Absence seizures (formerly known as “petit mal”)

Absence seizure is a generalized seizure that most often occurs in children between three and fourteen years of age. An absence seizure looks much milder than a tonic-clonic seizure and, in fact, sometimes looks like daydreaming. Therefore, primary school teachers often notice this disease earlier than everyone else.

Absence is usually characterized by a short-term shutdown of consciousness and staring at one point, blinking or rolling the eyes upward. Often, a child may experience 50 to 100 absence seizures per day. In most children, this type of epilepsy stops by puberty.

Myoclonic seizures

Myoclonic seizures can be described as jerks or contractions of the entire body or a group of muscles that are usually brief and last only a few seconds. People without epilepsy can also experience myoclonus, but myoclonic seizures in epilepsy usually cause abnormal movements on both sides of the body at the same time.

Juvenile myoclonic epilepsy: These seizures usually appear during puberty and often occur soon after waking up.
Progressive myoclonic epilepsy: This form of epilepsy is characterized by a combination of myoclonic and tonic-clonic seizures. These symptoms tend to get worse over time and are difficult to control.

Tonic seizures

Tonic seizures are characterized by sudden contraction and tension of muscles. Often a person's eyes may roll back into their head, and as their chest muscles tighten and tighten, they may have trouble breathing. These attacks are short in duration and usually last less than 20 seconds.

Clonic seizures

During clonic seizures, repeated muscle twitching and spasms occur. It is important to note that restraining or changing a person's position cannot stop these movements during an attack. Clonic seizures are considered rare.

Atonic attacks

During an atonic attack, muscles suddenly lose tone (or “strength”) due to temporary changes in brain function. These attacks are short-lived and usually last 15 seconds or less. Atonic seizures usually appear in childhood and continue into adulthood. Although the person usually does not lose consciousness and the seizures themselves do not cause bodily harm, indirect injuries can be caused by falling due to lack of muscle control. Atonic seizures are sometimes called “drop seizures” or “drop attacks”.

FOCAL SEIZURES – involving a limited area of the brain

Focal seizures (also known as “partial seizures” or “localized seizures”) are usually described by how they look and feel, for example:

Without impairment of consciousness or perception
Involving subjective sensory or mental phenomena
With impaired consciousness or perception, or dyscognitive
Progressing to a bilateral convulsive seizure

The different types of focal attacks are characterized/described by the main types of attack symptoms.

Simple partial seizures

A simple partial seizure may precede a complex partial seizure, in which case it is often called a “seizure aura.” Auras are often characterized by short-term discomfort in the abdomen or head, such as feeling anxious or high, a buzzing sound, an unpleasant odor, or spots before the eyes. People who can learn to recognize the onset of a seizure before it moves to other parts of the brain can use this as a warning to take precautions against possible injury during the seizure itself.

Complex partial seizures (also known as “temporal lobe” or “psychomotor” epilepsy)

The most common partial seizures are those that are now called complex partial seizures, but were previously known as temporal lobe or psychomotor seizures. A complex partial seizure consists of three short phases: the person stops what he was doing and there is a semi-conscious appearance and fixation of gaze. Then automatic, aimless behavior begins, which usually lasts several minutes. This may include smacking your lips, fiddling with clothing, buttoning and unfastening buttons, or twitching your fingers. When the person regains consciousness, a short period of disorientation and confusion follows.

Corrected classification of seizures (Report of the Commission of the International League Against Epilepsy 2005-2009)

Generalized tonic-clonic seizures (any type)
Absence Typical
Atypical
Absence with special characteristics
Myoclonic absence
Myoclonus eyelids

Myoclonic

Myoclonic atonic

Myoclonic tonic

Clonic

Tonic

Atonic

Focal seizures

Unknown

Epileptic spasms

(Symptoms that cannot be clearly categorized into one of the above categories)

Localized and generalized tonic seizures

Generalized convulsions : convulsions of the torso, limbs and lungs are added to muscle arrhythmia. The arms twist unnaturally, but the lower limbs remain in a relaxed state. The entire body is under extreme tension. The jaw closes tightly due to the tension on the face, and the head tilts towards the back. A person under such tension is rarely conscious. Generalized tonic convulsions are combined with epileptic seizures. A similar effect can occur due to the penetration of a toxic substance into the body.

Localized seizures are characterized by a paralytic effect on only one part of the body. Contractions do not occur constantly, but in portions, with short intervals. During localized convulsions, the person remains conscious. It is necessary to eliminate the source of irritation and provide rest for the body. No special medical skills are required to eliminate such seizures.

Differences between clonic and tonic seizures

A specific feature of tonic spasms is the sudden tension of all muscles. The body is held in a tense state for a long time. The cause of tonic seizures lies in the cerebral cortex. Convulsions can overtake the patient in his sleep if he was very active the day before. Spasms usually do not affect the facial muscles, respiratory system and arms.

Clonic seizures vary in frequency. Severe spasms are replaced by temporary relaxation. Irregular spasms occur on the face and hands. The torso is involved in a convulsion if the patient has developed attacks of epilepsy. Tonic and clinical convulsions occur alternately in acute epilepsy.

Cramps when stuttering

Tonic convulsions during stuttering bring enormous discomfort to the child. They are a spasm that lasts for a long time and prevents the child from speaking. May occur during speech. Tonic and clonic convulsions during stuttering differ in that the latter cause a short contraction of the muscles of the speech apparatus. The child’s speech in this case resembles talking in the cold, reminiscent of trembling.

There are three degrees of severity of stuttering seizures. In the first stage, stuttering and convulsions appear when a person speaks quickly or excitedly. Moderate severity means that the seizures are present even when the person speaks calmly. The severe stage occurs when the convulsions are prolonged and the stuttering is continuous.