Generalized Tonic-clonic Seizures

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[edit] Generalized tonic-clonic seizures

This is a full epileptic seizure, which starts with an outcry. Next there is a loss of consciousness and falling down to the ground. The muscles of the extremities, the trunk and the head are then first getting into tonic (rigid spasm) contractions.

This is followed by muscle shaking (clonic contractions). During this seizure, which lasts about 1 to 2 minutes, urinary and fecal incontinence may happen. This type of seizure may follow an initial simple partial seizure or a complex partial seizure. In this case this would be termed a secondary generalized tonic-clonic seizure.

Treatment:

The drugs of choice for these seizures are phenytoin (brand name: Dilantin, Phenytex, Diphenylan), carbamazepine (brand name: Tegretol, Novo-Carbamaz) and valproic acid (brand names: Depakene, Deproic). If this does not control the seizures adequately, the neurologist may add some other anti-seizure drug or switch to another drug altogether. Such other drugs would be, for instance, phenobarbital, primidone (brandnames: Mysoline, Myidone) or lamotrigine (brand name: Lamictal). Here is a site that lists the stabilizing effects of some of the anticonvulsive medications mentioned.

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References:

1. F Zara et al. Am J Hum Gen 2000 May 66(5): 1552-1557.

2. S Yeung et al. Europ J Paediatr Neurol 2000; 4(1): 31-33.

3. LS Leung et al. Neurosci Biobehav Rev 2000 Sep 24(7): 763-775.

4. DJ Yen et al. Epilepsia 2000 Sep 41(9) 1162-1166.

5. E Starreveld et al. Can Fam Physician 2000 Sep 46: 1817-1823.

6. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 172.

7. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 271, p.2415.

8. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

9. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier