To begin with, let's divide all seizures into generalized, when the whole body is subject to a convulsive attack, and local, when only one area is affected - for example, the calf muscle.
There are also tonic and clonic seizures. The first ones are more like not a cramp, but a spasm, in which the body seems to be frozen in one position. A classic example of a tonic seizure is opisthotonus in tetanus. Such seizures are rare and are always caused by a serious illness: tetanus, neuroinfection, brain tumors.
The second option is clonic convulsions, in which the body makes frequent chaotic movements, that is, it beats in a typical convulsive seizure, as most of us imagine it.
This option can be encountered much more often in life - these include febrile convulsions when the temperature rises in young children, and epileptic seizures in people of any age. If your leg is cramped or your biceps is constantly twitching, this is unpleasant, but not dangerous.
If we are talking about generalized seizures, a person needs quick medical attention. Although neurologists like to repeat that a seizure is not as terrible as it looks from the outside.
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.
Chapter 2.
What are the types of seizures? How they develop and proceed.
You need to have this booklet-memo, since the correct diagnosis and treatment of attacks is primarily determined by how accurately and in detail you can tell the doctor about the attack. Reading the booklet will help you create a written description of the attack, with which you can go to the doctor and receive the correct treatment.
The first page of this booklet will not be used by you to describe seizures - it is just a summary of the main types of seizures. I put it here so that you understand that seizures come in different varieties, and that your description of seizures is of great importance for diagnosis. Do not try to make a diagnosis yourself based on these brief descriptions. The actual diagnosis of seizure type is much more complex.
The most common seizures in adults and children are manifested by various convulsions - in the form of twitching or muscle tension in the limbs and (or) other parts of the body. Convulsions in all parts of the body are usually accompanied by a disturbance of consciousness and are called GRAND SEIZURES. At the beginning of a LARGE ATTACK, a person may scream or freeze in place, then he falls, the body stretches out and twitching begins. Such an attack lasts several minutes.
However, there may be disturbances of consciousness without convulsions - “ABSENCES”. This name translated means “absence” - a person freezes with a fixed gaze for one or several seconds. Those actions that a person carried out before the attack stop or slow down during freezing. So, for example, if he was writing before an attack, he may drop the pen or draw an uneven line instead of letters. Such attacks in children can be repeated during the lesson. If a child who is considered healthy periodically freezes with his gaze fixed on one point, or seems to “daydream” for several seconds, or is often “distracted” in class, he may actually have seizures of the absence seizure type.
Less common are COMPLEX PARTIAL SEIZURES (COMPLEX FOCAL, including PSYCHOMOTOR SEIZURES). With them, the disturbance of consciousness is not so noticeable externally, but is longer lasting (from a minute or longer) and is manifested not by a loss of consciousness, but by unusual or abnormal behavior. You can therefore have time to assess the state of consciousness by asking a child or adult with a seizure a question, for example, “Can you hear me,” and not receiving a clear answer to this. During such a psychomotor attack, a person can talk incoherently, without meaning, laugh, or shout. MOTOR (motor) manifestations of a PSYCHOMOTOR attack in children may consist of getting up from their desks, aimless movements around the classroom, or limited to smacking, sucking movements, unnecessary movements of the fingers or hands, etc. The teacher may confuse such attacks with behavioral disorders or self-indulgence.
During absence seizures and some psychomotor seizures, a person does not remember what was happening around him at the time of the attack, including what others approached him with. Such attacks may be subtle to the person and others. Therefore, in childhood, the teacher must analyze the nature of errors in written work, which may be caused by short-term blackouts.
Many other rarer types of seizures may occur, which usually include some elements of the structure of the seizures described above. In the diagnosis of a seizure type, many other terms may be used, not just those listed above.
WHAT FAMILY AND AROUND SHOULD PAY ATTENTION TO DURING AN ATTACK SO THAT THE DOCTOR CAN CORRECTLY IDENTIFY THE TYPE OF ATTACK AND PRESCRIBE THE CORRECT TREATMENT. SCHEME-QUESTIONNAIRE FOR DESCRIBING AN ATTACK.
To select the most effective anti-epileptic drug, it is necessary to accurately determine the type of seizure, since different drugs have different effects on different types of seizures. Some features of seizures also make it possible to determine in which area of the brain the main epicenter is located.
Therefore, during an attack, do not panic. Firstly, follow the recommendations for help during a seizure (see recommendations: “HOW TO HELP WHEN AN ATTACK OF CONVISIONS OR CHANGES IN CONSCIOUSNESS”). Secondly, carefully monitor the attack and, at the earliest opportunity, immediately after its completion, write down your observations. This must be done not only before the first visit to the doctor, when it is necessary to first establish the type of attack or clarify it. You must describe the attack again after a doctor has diagnosed the type of attack if the nature of the attacks changes or if a new type of attack appears.
It can be quite difficult to accurately describe the epileptic attack itself. The patient himself often has a memory loss at the time of the attack and is unable to describe the attack himself after regaining consciousness. Witnesses of an attack, as a rule, are too shocked, helpless and, out of excitement, do not pay attention to details. Since the details of the attack have different meanings, below is a diagram highlighting the most important points in the description of the attack. Additional comments are provided next to some questions or groups of questions. Use them if you find it difficult to formulate an answer to a question.
If you or your loved one has not one, but several types of attacks, then carry out the description below separately for all types of attacks.
It will be much easier for you to describe the attack if, as quickly as possible after the attack, you write down the answers to the following questions:
QUESTIONS FOR A PERSON WITH SEIZURES:
How does an attack begin? Are you conscious throughout the attack or is there some lapse in memory? Does the blackout end suddenly, literally immediately, or does it take some time for you to feel completely normal? How long does it take you to finally come to your senses? How do you feel during an attack? How do you feel after an attack? Do your muscles hurt after an attack? Are there any bruises after the attack? In what parts of the body? Are there any bites of the tongue, lips, or oral mucosa after the attack?
If the person did not have a memory loss during the attack or the memory loss was incomplete or partial, then he is asked the same questions below as the witnesses of the attack: QUESTIONS FOR THE WITNESSES OF THE ATTACK (AND THE PERSON WITH THE ATTACK, IF HE REMEMBERS ANYTHING ABOUT IT ):
1. BEGINNING OF THE ATTACK. How did you determine the onset of the attack (how did you understand that the attack had begun)? What did you immediately notice? Has your facial expression changed? Is your face turning pale? Are your eyes open? Does the gaze stop (fixed gaze)? Are your eyeballs rolling under your forehead?
1.1. UNILATERALITY OF ATTACK MANIFESTATIONS AT ITS BEGINNING. Do the eyes and/or head turn in one direction? Which way? Is there any other one-sidedness of movement, cramps or sensations at the onset of the attack? Did movements or sensations begin in any isolated part of the body?
Comment: In order for the doctor to determine in which half of the brain the epi-focus is located, you must identify the one-sided manifestation of the attack at its onset. This is indicated by turning the head and eyes in a certain direction before the onset of convulsions, one-sidedness of sensations or the onset of convulsions, etc. A more precise localization of the focus can be established if cramps or sensations begin not in the entire half of the body, but in part of it (in the fingers or hand, corner of the mouth, etc.).
1.2. WAS THERE AN AURA AT THE BEGINNING OF THE ATTACK? If there was, describe it.
Comment: When describing the nature of the attack, it is very important to identify whether the child or adult feels the approach of the attacks and how. These sensations at the very beginning of attacks are called “AURA”. Although the word "aura" is translated as "wind blowing", it can also manifest itself in other sensations. The nature of these sensations at the very beginning of the attack allows an experienced doctor to determine the location of the epi-focus in the brain and use this information to select the most effective treatment. The fact is that an aura is the result of irritation of a certain area of the brain by an epi-focus existing in this area of the brain. In addition, some people manage to prevent the further development of an attack at the time of the aura if they influence their sensations in a certain way (see recommendations: HOW TO HELP DURING AN ATTACK OF CONVISIONS OR CHANGES IN CONSCIOUSNESS. HOW TO HELP BEFORE AN ATTACK).
The sensations that a person experiences during an aura are varied. This may be a sensation of warmth radiating from the abdomen or chest. An aura can be expressed in the form of a sudden appearance of an unusual or familiar smell in the absence of its real cause in the room, sound or vivid visual images (auditory and visual hallucinations). In addition, the aura can manifest itself in a feeling of detachment, novelty when being in a familiar environment, or vice versa - a feeling of the familiar, already experienced, which suddenly appears in an unfamiliar situation. Unusual obsessive thoughts and emotions may be observed (fear, anxiety, depression or euphoria, anger for no reason). There may be other sensations during the aura, which are characteristic only for a given person. There may be more or more familiar sudden sensations - shortness of breath, palpitations, pain in some part of the body, abdominal pain, nausea, dizziness, etc.
Immediately before the attack, a person’s behavior may also change - the child may run up to you or try to lie down, looking for a safe place.
It is necessary to immediately ask the child or adult what he feels at this moment and during the aura, since after the attack he may forget his feelings.
Particularly important is the description of a person’s sensations when he feels an attack (aura) approaching, but for some reason the attack itself does not develop. Such an attack is called PARTIAL ("partial") ATTACK, since the entire picture of the attack is limited to an epi-discharge in a limited part of the brain (aura). Depending on which sense organ (vision, smell, hearing, taste, touch) is represented in this part of the brain, the SENSORY (sensitive) version of PARTIAL ATTACK is limited to such sensations.
The duration of the aura before the onset of the main part of the attack is also important - if the aura lasts 1-2 seconds, then the epi-focus can be located in the temporal region, with a longer aura - in the frontal lobe of the brain.
2. MOVEMENTS DURING AN ATTACK:
2.1. CONVISIONS: Have you had any seizures? If noted, which ones (check among those listed below).
2.1.1. JERKINGS = CLONIC CONVASIONS:
In what parts of the body were clonic twitches noted? Were there twitches on both sides or in one half of the body or face?
Comment: Clonic seizures are rhythmically repeated twitches. Most often, they involve rhythmic flexion or extension of the limbs. These limb movements are of small amplitude or volume. There may be repeated rhythmic tremors of the body, rhythmic twitching of the facial muscles, sometimes with rhythmic squinting (blinking) of the eyes.
2.1.2. JIVERING:
In what parts of the body was trembling noted? Was there shaking on both sides or on one side of the body or face?
Comment: Trembling is a hythmic, very frequently repeated twitching of very small amplitude (without changing the position of the limb). General trembling (chills) occurs if a person is cold (“Trembling from the cold”)
2.1.3. JERKES = MYOCLONIUS:
Were there general shudders (myclonias) of the whole body? Was there one general startle during the attack or several? Was the general flinching accompanied by flexion or extension (throwing) of the torso and limbs? Were there jerks (myclonia) in specific parts of the body or muscles, and not in the whole body at the same time? In what part of the body? How often did the flinching occur?
Comment: Unlike clonic convulsions, myoclonus is a separate (isolated) sharp, very fast (tenths of a second) startle, and not rhythmic repeated twitching. If myoclonic jerks are repeated throughout the attack, then, unlike clonic spasms, not often and at different intervals (not rhythmically).
2.1.4. TONIC CONVASIONS:
Was there at the beginning of the attack or during its course a tonic tension of the whole body with throwing back of the head, extension of the whole body in the form of an arc? Was the body tense during the attack or was it sluggish and limp “like a rag”? Was there a tonic contraction of the limbs or slow involuntary tense movements? In which limbs? In what position were the limbs brought together? Is the corner of the mouth pulled to the side? Was there a facial grimace? Does the skin around the mouth turn blue during an attack? Does your whole face turn blue? Are there any other changes in complexion (pallor, purplish-red coloration)?
Comment: Almost every one of us has experienced non-epileptic tonic cramps in the calf muscles or seen them in our loved ones - the calf muscles become hard (petrified) to the touch, you experience pain, and the foot “cramps” into a flexed position. Epileptic tonic convulsions also consist of muscle tension. The muscles become hard and tense - the limbs and body are pulled out or they freeze in an unusual position. Such tonic convulsions, if they occur in the muscles of the torso, can be accompanied by breath holding due to convulsive contraction of the respiratory muscles - while the person’s face begins to turn blue. “Stationary” tonic convulsions at the beginning of an attack are then usually replaced by variable muscle tension, which is therefore accompanied by slow movements of the body and limbs (the duration of one such tonic movement is 10 seconds or more). During other attacks, muscle tone may, on the contrary, decrease and the body becomes limp, like a “rag.”
2.2. OTHER MOTOR ACTS DURING A SEIZURE:
What repeated stereotypical (all the time the same) manipulations are performed by the patient’s hands: clapping, patting, rubbing, tugging or other movements? If the patient continues to sit during an attack, what do his legs look like: calm or in motion?
If a person remains on his feet during an attack, is he standing still? Does it rotate around the axis of the body? Does it freeze in a certain position? If he doesn’t stand still, how does he move during an attack?
Were swallowing movements, chewing, sucking, or licking lips noted? Is the attack accompanied by any sounds - grinding teeth, smacking, hiccups, slurping, swallowing, meowing, sobbing, moaning, or are individual words heard? Is there a scream, or a strangled growl, or wheezing, gurgling breathing?
Were there general chaotic violent movements during the attack?
Did you urinate during the attack?
2.3. FALL DURING SEIZURE. Did the fall occur during the attack if the patient was standing before the onset of the attack? If he was sitting with support during the attack or was supported, could he fall in the absence of support and support? How did you fall - did you slowly sag? Did your legs suddenly give way? thrown to the floor by a body push? Does it always fall in one direction (which?) or only backwards? or just forward?
Comment: with unexpressed convulsions, a person can stay on his feet or still fall. It is necessary to determine whether the person can independently stand on his feet during any attack without severe generalized convulsions. If a fall occurs, it is important to know whether the person fell sharply or slowly sank to the ground.
2.4. ARE THERE ANY INJURIES AFTER THE ATTACK? Are there any bruises? In what parts of the body? Are there any bites of the tongue, lips, or oral mucosa? Is there a pink color to the saliva during an attack or immediately after it?
3. STATE OF CONSCIOUSNESS DURING AN ATTACK.
Does the person with seizures answer your questions? If he answers, how correctly and clearly? Ask him in detail about his feelings and what happened to him. If he doesn’t answer questions, then does he react in any way to your approach to him by fixing his gaze on you, following your movement, fulfilling your requests and instructions? If consciousness is preserved, is it maintained throughout the entire attack or is it possible that it can be switched off or changed at some point during the attack? If so, how and when does it change?
Comment: it is important to find out whether there is a disconnection or change in consciousness during an attack (whether the person reacts and how to an address to him, whether he follows with his eyes, whether he tries to respond to your address to him). A complete loss of consciousness is a sign of GENERALIZED seizures, in which the “electrical discharge” in the head is not limited to a part of the brain, but spreads (generalizes) to the entire brain. During some attacks there are no convulsions, but only a loss of consciousness is noted. There may also be an altered state of consciousness in the form of unusual sensations, experiences, hallucinations, delusions or unusual behavior
4. SPEECH IMPAIRMENT DURING ATTACK. If the attack occurs without impairment of consciousness, then it is necessary to check whether the person can choose the words correctly and pronounce the words correctly in response to your questions? Does he clearly pronounce sounds and syllables?
5. CONDITION OF CARDIAC ACTIVITY - it is necessary to evaluate the pulse only in case of fainting-like attacks. Is the pulse rapid or slow? Were there any pulse interruptions (pauses between heartbeats)?
6. DURATION OF ATTACK AND CONDITION AFTER ITS END
How does the attack end - suddenly or gradually with fading convulsions and movements? How long did the attack last? Did it last 1-3 minutes? Did it last longer? If you lose consciousness during a seizure, is it possible to establish contact with the person immediately after the seizures (or other movements) stop? If not immediately, then after how long? Does any part of the body remain weak after the attack? How long? Does speech impairment remain after an attack with normal consciousness? What kind of speech impairment (see point 4) and for how long? How many minutes (hours?) after the end of the attack is the person’s condition completely normalized and can he continue his normal activities?
7. WHAT TO PAY ATTENTION TO WHEN AN ATTACK OCCURS DURING SLEEP? At what part of the night do the attacks occur? Right after falling asleep? When you wake up? How many hours after falling asleep? In the morning? Does the attack develop during deep or restless sleep? In general, is sleep itself deep or restless?
Comment: HOW TO DETECT SEIZURES DURING NIGHT SLEEP.
Parents and relatives may not notice nocturnal attacks in a child or adult - their sign may be pain in the mouth and tongue in the morning (when examining the oral cavity, you can find traces of biting the tongue or cheeks, which happened at night due to spasm of the jaws during an attack) or complaints the child has them on them. Sometimes after a night attack you can find traces of saliva on the pillow (including with a pinkish tint). A sign of a nocturnal attack may also be a case of nighttime urinary incontinence that is unusual for a given child or adult. If there were cramps at night, in the morning there may be pain, aches, fatigue or stiffness in those muscles that tensed during the night cramps. Unusual lethargy, fatigue and headache in the morning can also be a consequence of an attack that occurred in the morning.
If you suspect possible night attacks, it is advisable that someone from the family sleeps in the same room with a child or adult, you should leave the doors open at night in order to promptly hear sounds that may accompany an attack: shaking of the bed, wheezing breathing, etc.
8. WERE THERE ANY PREDICTS OF THE ATTACK? If there were, describe them. Comments: There may not only be an aura immediately before an attack; sometimes, several hours or even days before an attack, a person may become lethargic, tearful or irritable. He may have a headache or decreased appetite. Using such PREDICTS, an adult patient or a child’s parents can foresee the possibility of an attack in advance. If you do not notice any warning signs, ask a relative or loved one to observe you. Precursors of attacks are more clearly and reliably identified in the process of more or less long-term observation of attacks, if the attacks are repeated (see and use the “DIARY (CALENDAR) OF ATTACKS”).
9. WHAT CAUSED THE ATTACK? If there was a reason for the attack, describe it. Comment: most often, an attack develops spontaneously, without any external causes, since its development is caused purely by its own processes inside the brain, not related to the external environment. However, in a minority of people, certain “external” causes and influences can contribute to the occurrence of a specific seizure (provoke it). This can occur with reflex epilepsy (read the recommendations “WHAT IS EPILEPSY, EPILEPSY, AND EPI-REACTION. PROGNOSIS FOR SEIZURES”). You should carefully look for these provoking factors and suspicious circumstances that preceded the next attack and record them in your diary (to do this, read and follow the recommendations “LIFE STYLE DURING EPIC ATTACKS”). Identifying some of these triggers and avoiding them in the future may make it possible to reduce the effective dose of the antiepileptic drug taken. The doctor may also prescribe auxiliary means and methods to influence these provoking factors to prevent attacks.
However, most often, attacks can be provoked by a violation of the rules for taking medications set out in the recommendations: “HOW AND WHAT YOU CAN HELP YOURSELF, YOUR LOVED ONE OR CHILD IN THE PRESENCE OF SEIZES. THE MAIN METHOD FOR TREATING ATTACKS.”
Factors causing or provoking attacks are more clearly and reliably identified in the process of more or less long-term observation of attacks, if the attacks are repeated (see and use the “DIARY (CALENDAR) OF ATTACKS”). If you don't know what triggers your attacks, ask a relative or close friend to help you. They may notice the following symptoms:
1) how active (or inactive) were you (or the patient) before the attack began? Were you lethargic (drowsy) or excited (irritated, emotional) before the attack? Did you engage in any active (mental or physical) work before the attack, actively had fun or passively rested. Was the attack caused by any thought, stress, expressed emotion?
2) did you have a “lack of sleep” on the eve of the attack (was the attack triggered by insufficient sleep duration - went to bed late, got up early?)
3) did you drink wine, beer or strong alcoholic drinks the day before the attack? How much did you drink?
4) what did you eat before the attack and how much (too much, too little, some unusual dish or product)? Did the attack occur when you were hungry (skipped your usual meal)?
5) did the development of the attack coincide with any other unusual situation or circumstances?
To the table of contents of the article “Convulsions, epileptic seizures and epilepsy.”
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.
Treatment
Help before diagnosis
At the prehospital stage, for local spasms, it is recommended to rub and massage the affected area, stretch the muscles cramped by tonic cramps. In the event of a generalized attack, it is necessary to protect the patient from possible injuries and provide access to fresh air. The emergency medical team that arrived on call carries out symptomatic correction with anticonvulsants.
Conservative therapy
The basis of traditional treatment of tonic seizures is drug therapy, the purpose of which is to eliminate symptoms and influence the causes and mechanisms of development of the underlying disease. Considering the extensive etiological structure of the convulsive syndrome, various medications may be present in its correction regimens:
- Symptomatic.
To eliminate convulsive attacks, anticonvulsants (tranquilizers, antiepileptics) and sedatives are indicated. Febrile seizures are controlled by the administration of antipyretics. - Pathogenetic.
The disturbed balance of electrolytes is restored with calcium preparations, magnesium sulfate, and saline solutions. Hypoglycemia requires the administration of glucose; in Gaucher disease, glucocerebrosidase is used; in many cases, detoxification therapy is indicated. - Etiotropic.
Infectious pathologies are treated with antiviral agents, antibiotics, and according to indications, anti-rabies and anti-tetanus immunoglobulins are used. Correction of neurogenic seizures is carried out with mood stabilizers and anxiolytics.
Some seizures that are resistant to medication may benefit from a ketogenic diet. The nature of nutrition plays an important role in the treatment of hereditary enzymopathies and electrolyte disorders. Non-drug methods also include massage, exercise therapy, and psychotherapy. Severe poisoning requires extracorporeal detoxification.
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.
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.
Diagnostics
Sometimes it is possible to guess the cause of clonic seizures clinically - according to the anamnesis and neurological examination. At the same time, attention is paid to the time and circumstances of the attack, its nature, and the presence of accompanying symptoms. But in most cases, an accurate diagnosis is established based on the results of additional procedures:
- Laboratory tests.
For infections, microscopy and culture of biomaterial (nasopharyngeal mucus, sputum, liquor) are prescribed; serological tests; DNA or RNA of the pathogen are detected by PCR. Children with storage diseases undergo enzymatic diagnostics; in case of poisoning, a toxicological analysis is indicated. - DNA diagnostics.
Verification of hereditary diseases is carried out by cytogenetic study of the karyotype, analysis of a panel of genes or individual mutations. The risk of developing pathology in the fetus can be determined through prenatal testing. - Neuroimaging.
Structural defects are detected by tomography. In cases of diffuse damage to brain tissue, MRI shows signs of encephalopathy (hyperintense foci in the cortex, cerebellum or brainstem), atrophy. CT scan of the brain shows scattered calcifications in tuberous sclerosis. - Electroencephalography.
Epileptic and non-epileptic paroxysms are an indication for an EEG. The study makes it possible to establish the localization of seizure activity (focal, multifocal, generalized), its morphology (waves, peaks, “jogs”), frequency and other characteristics.
The neurologist is assisted in diagnosis by related specialists. A characteristic sign of Tay-Sachs disease - a red spot on the retina - is determined by an ophthalmologist during ophthalmoscopy; hereditary pathology requires the involvement of a geneticist. It is necessary to differentiate clonic convulsions from paroxysmal conditions of a different origin: stereotypical movements, syncope, pseudoconvulsions.
Causes of tonic seizures
Causes of seizures include:
- Disturbed neurology
- Diseases of the cardiovascular system, swelling.
- Infectious diseases
- Poisoning of the body
- Hysterics
- Sprains and microtraumas
- Overheating and lack of water in the body
- Depletion of the body in vitamins and minerals
- Diabetes, kidney disorders, impaired thyroid function.