Health, medicine, healthy lifestyle. Types of seizures Tonic-clonic seizures in children

Etiology and pathophysiology
The traditional (obsolete) name is a grand mal seizure. These generalized seizures may be accompanied by an aura, loss of consciousness and a fall, the tonic phase lasting 10-20 seconds, the clonic phase a little longer, followed by a postconvulsive period that can last several hours.
The disease may be genetic in nature.
- Usually on the EEG it is manifested by peak-wave complexes with a frequency of 3 per second.
- As a rule, cramps occur early in the morning, usually immediately after waking up.
- They are often preceded by myoclonic jerks.
Cases of acquired disease are considered as secondary generalized convulsions, initially manifested by partial convulsions.
- Secondary seizures can be caused by any brain injury, including stroke, tumor, trauma, and infection.
- Another common cause of this type of seizures may be drug or alcohol withdrawal.
- Predisposing factors may be metabolic disorders (eg, hyponatremia, uremia, hypocalcemia, liver failure).
May occur at any age: generalized seizures often first appear before the age of 2 years; as a rule, the disease begins before the age of 20, the second peak of incidence occurs at the age of over 60 years.

Differential Diagnosis
Fainting.
Convulsive fainting.
Psychogenic convulsions.
- Alarm attack.
- Panic attack.

Symptoms
Usually begin with a generalized tonic torpor of all limbs in the extension position.
- There is a contraction of the diaphragm, causing a loud growling sound as air is forcefully expelled from the chest cavity.
After the tonic phase, generalized clonic twitches of all limbs are noted, the arms are in a state of flexion; the clonic phase lasts 30-90 s.
- Tongue biting, urinary incontinence, feces.
After the attack, the postconvulsive phase occurs, when the patient has confusion / disorientation for 10-30 minutes. Seizures may be followed by focal neurological defects often referred to as TOAD phenomena (eg, aphasia, hemiparesis, hemisensory defects).

Diagnostics
Most important for making a diagnosis is an accurate description of the incident, which is usually given by the observer; the duration of the episode, the alternation of the tonic and clonic phases and the postconvulsive period of confusion are of primary importance.
- On the EEG taken in the postconvulsive period, there is a generalized slowing of the signal, focal or generalized peaks (spikes) may be detected; during an attack on the EEG, epileptiform disorders are determined - focal peaks or generalized peak-wave discharges.
CT or MRI can often detect a focal lesion.
Post-traumatic victims with generalized tonic-clonic seizures typically experience additional damage during the seizure (eg, fractures, abrasions, concussion, tears).
Laboratory signs of a generalized seizure: increased activity of creatine phosphokinase and prolactin levels.
It is necessary to take blood for the study of the content of drugs and alcohol in it.
If a hemorrhage or infection of the central nervous system is suspected, a CSF examination is performed.

Treatment
Many drugs are effective.
- In primary (genetically determined) generalized convulsions, valproate remains the drug of choice.
- For secondary generalized seizures, many drugs have similar efficacy: phenytoin, phenobarbital, topiramate, lamotrigine, zonisamide, levetiracetam and carbamazepine.
- These antiepileptic drugs have comparable efficacy in the treatment of generalized tonic-clonic seizures; they differ mainly in side effect profile, drug interactions and tolerability.
The patient should stop taking drugs and alcohol. If metabolic abnormalities are detected (for example, hyponatremia, uremia), they are corrected. It is necessary to periodically monitor the level of the drug used for treatment in the blood, indicators of liver function and parameters of a clinical blood test.

Important Notes
When a generalized seizure occurs for the first time, 1/3 of patients are likely to have a second episode within the next 2 years; this risk can be assessed with greater accuracy on follow-up EEG monitoring (detection of EEG abnormalities increases risk). This type of seizure usually responds well to medical therapy and the prognosis is good.
The prognosis also depends on the etiology of seizures (in the presence of focal brain pathology - stroke or tumor - the risk of recurrent seizures is higher than with idiopathic generalized seizures).
If convulsions occur due to drug or alcohol withdrawal, anticonvulsant therapy may not be required.
In most countries, after an episode of a seizure or loss of consciousness, the patient is deprived of the right to drive a car for a period of 6 months. up to 1 year.

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 a consequence 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.

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. and the main reasons are micronutrient deficiencies, hypothermia, excessive physical activity. 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.

Tonic muscle cramps, what is it?

Tonic spasms are involuntary muscle contractions that occur against the background of pain. In addition to clinical seizures, there are also clinical, tonic-clonic seizures. Whatever types of seizures are noted in a patient, it is always important to make a correct diagnosis in a timely manner and eliminate the consequences of the occurrence of convulsive contractions. To conduct a timely and accurate diagnosis of the patient's condition, a complete medical examination is required.

Regarding tonic convulsions, it should be noted that they are accompanied by more than one spasm. Muscles continue to twitch rhythmically with a certain frequency for some time. In the case of a combination of tonic and clonic convulsions, a tonic-clonic spasm occurs.

Attack of tonic convulsions

A tonic attack is characterized by the manifestation of rigidity of the arms, trunk and legs. The attack is short enough, so it does not occur clonic phases.

Convulsive muscle contractions in an attack are a consequence of damage to the human nervous system. They can occur at different stages of the patient's life, their causes are negative aspects on the part of the patient's mother, if we are talking about early childhood, and the reason may also be in the abnormal development of the child in the mother's womb. Often these diseases are inherited.

An attack of tonic convulsions in children indicates the development of pathological processes in the child's nervous system, as well as its endocrine system and an abnormal metabolic process. Limbs with such attacks rise and stretch.

Attacks of tonic convulsions differ from all other seizures in that during these attacks the upper limbs of the patient change their position and the person begins to wrap his face around, as if protecting him from possible damage. An increase in blood pressure is noted, the reaction to light stimuli weakens, breathing becomes frequent. In more severe cases, there is a loss of consciousness by the patient, which is very dangerous due to possible falls and injuries.

Localized and generalized tonic seizures

With generalized tonic convulsions, the muscles of the trunk, limbs, and upper respiratory tract are involved in convulsive contractions. Basically, the arms are bent and remain in a similar state for a long time. Most often, the legs remain unbent and tense. The torso stretches and tenses, the head leans back and turns, while the teeth are compressed. Consciousness can either be preserved or be lost. Such tonic convulsions are most often associated with the manifestation of epileptic seizures, but they are also possible with rabies, hysteria, tetanus and other diseases. In addition, they can develop as a result of acute poisoning, in particular, as a result of strychnine poisoning.

Localized tonic convulsions are characterized by their localization in any part of the patient's body. Contractions are marked partial, passing in a few seconds, they are not accompanied by loss of consciousness. In such cases, it is required to provide the patient with peace, to eliminate all external stimuli from him. No special, narrowly specialized treatment should be applied in this case.

Differences between tonic and clonic seizures

Tonic convulsions are characterized by a sharp tension in all the muscles of the body and holding them in a subfrontal position for some time. Such convulsions occur rather slowly. As a rule, the reason for this phenomenon lies in the excessively strong excitation of the subcortical structures in the patient's brain. In the bulk of the observed cases, tonic convulsions covered the muscles of the leg, they are noted in the patient in a dream, due to his excessive activity the day before. Somewhat less often, such convulsions affect the patient's face, his airways, and also his hands.

At the same time, the causes of clonic convulsions lie in disorders of the cerebral cortex. They manifest as synchronous muscle contractions alternating with periods of relaxation. Muscles located on the periphery may be affected, in such cases, non-rhythmic contractions are noted. If a patient develops seizures of epilepsy, the rhythm of convulsions takes place, the muscles of half of the body are gradually involved in them, as well as several different muscle groups. In some cases, with an epileptic seizure, a periodic change of tonic convulsions into clonic ones can be noted, with a preceding aura, the manifestations of which differ.

Tonic convulsions: causes

The following causes of tonic seizures in a patient can be noted:

• various pathologies of a neurological nature, such as violations of blood washing of the brain, trauma to the skull, penetration of infections into the brain;
• infection with infectious diseases: tetanus, childhood diseases, various steels of rabies, as well as other diseases in which there is an increase in the patient's body temperature;
• intoxication of the patient's body due to the development of an acute form of renal failure;
• heat stroke, causing disturbances in the water-salt balance in the body;
• fits of hysteria.

In the event of tonic convulsions, the patient has a rapid development of spasm.

Tonic convulsions: symptoms

With the development of tonic seizures, the patient develops the following symptoms:

• hardening of muscles of various groups;
• the occurrence of severe pain in the muscles;
• a sharp change in facial expressions at the time of the onset of a convulsive seizure.

In addition, the body in such cases may arch unnaturally, the legs are straightened, and the arms are bent, the head is thrown back. In some cases, seizures may be accompanied by loss of consciousness by the patient.

Tonic convulsions: treatment

For high-quality treatment of tonic convulsions, the cause that caused them should be eliminated. This requires, in case of autonomic dysfunction, to take drugs that provide a sedative, vegetotropic and tranquilizing effect. If the cause of the patient's condition lies in his hysteria, it is necessary to conduct psychotherapy sessions, as well as the use of funds that are well able to calm the patient.

In the event that the cause of the patient's condition lies in seizures of epilepsy, it is necessary to use drugs that cause inhibition of reactions. With local convulsions, areas of increased tension should be eliminated through the use of novocaine blockade and physiotherapy.
drugs for tonic seizures

The choice of drugs for tonic convulsions is dictated by the cause that caused them. If convulsions are neurogenic in nature, it is necessary to use Sibazon, Bellataminal, Mezapam to eliminate them. If convulsions are caused by hysteria, the use of Frenolon, Phenazepam, and Azafen is required. If the cause of tonic convulsions was the disease of a patient with epilepsy, it is recommended to use

Today we will talk about tonic convulsions. We will find out what it is, get acquainted with the causes and treatment, and also try to figure out how to provide first aid.

It should be understood that most often tonic convulsions occur when a person becomes ill with something. Seizures can be caused by many factors. However, their appearance is accompanied by a number of other symptoms that require immediate treatment.

What it is?

It is believed that a spasm is a reaction of the human body to an irritant. It can be an external or internal stimulus. The aggressive effect of certain factors on the body provokes pathology in a group of nerve tissues. They, in turn, transmit nerve impulses to muscle sections throughout the body. It is generally accepted to consider tonic convulsions as a type of convulsive seizures.

What is the feature? With such convulsions, almost all human muscle tissues are involved, that is, the spasm is very extensive. This implies that during a spasm, a spasm of muscles that, for example, provide breathing, may occur. In this case, the outcome can be fatal if timely medical care is not provided.

Clonic convulsions

The main difference between tonic and clonic convulsions is that during the latter, muscle spasms alternate with their relaxation. Clonic convulsions are those involuntary muscle contractions that a person may not even notice at an early stage of the disease. Tonic spasms are long. Clonic are smoother, they are only local. In this case, there are often convulsions of the respiratory system, which can lead to the development of stuttering.

Symptoms

Tonic convulsions, the symptoms of which can be varied, can still be identified. The main manifestations: pain in the body, shortness of breath, flexion of the arm in the elbow joint, which occurs spontaneously, spasms of the jaw muscles, muscle contraction for a long time, disorders of the musculoskeletal system, body tension.

These are the main symptoms that appear in almost all patients. In this case, often a person throws his head back involuntarily. This causes muscle spasms in the cervical and back regions. One of the most unpleasant symptoms is involuntary urination or defecation. If you find this symptom, you should immediately go to the hospital, and not treat the gastrointestinal tract at home. The reason for this symptom is the spasm of the muscles of the body, which are responsible for retaining fluids.

It should be noted that the symptoms listed above are very similar to those that patients experience during a seizure. A distinctive feature of tonic convulsions is their duration. Unfortunately, spasms can last for hours. It will take even longer to restore the body to a normal state.

It is important to remember that the convulsions described are a type of convulsive seizure, but the symptoms have their own characteristics.

Causes

We have already figured out what tonic convulsions are. What are their reasons? The main cause of convulsions and seizures is a violation of the activity of the human nervous system. However, to date, it is not exactly known which one causes convulsions. But scientists have an assumption that the cause is the increased excitability of the subcortical region of the brain. There is also a generally accepted list of the most likely causes of seizures:

1. Violation of metabolic processes. There is a huge variety of pathologies associated with metabolic processes in the body that can adversely affect the functioning of the brain. There are frequent cases of seizures due to insufficient amounts of calcium. A provoking factor can be oxygen deficiency in the brain, high sugar, the presence of toxic substances in the body.
2. Epilepsy. This disease is very similar to tonic convulsions, which do not last long. The frequency of seizures depends largely on the severity of the disease itself. The seizure usually lasts up to 5 minutes, during which the person loses consciousness.
3. Infectious diseases. Even then, a seizure may occur. It usually begins with the mimic muscles of the face, and then falls below. In this case, everything is accompanied by profuse sweat and rapid heartbeat. Most often, convulsions occur with tetanus and polio.
4. Pregnancy. The special condition of the woman's body can contribute to the occurrence of seizures (clonic and tonic). The reason is the swelling of the brain, which is observed in late pregnancy. The seizure may be accompanied by weakness, worsening of the general condition and an increase in blood pressure.
5. Disorders in the work of the thyroid gland. Hormonal imbalances are another possible cause. Typically, seizures are characteristic of people whose thyroid gland is completely or partially removed.

As we already understood, the causes of seizures can be different, but the root of the problem lies in the work of the nervous system.

Diagnostics

Tonic seizures can occur in both adults and children. In this case, it is very important to immediately consult a doctor. Very often, people attribute convulsions during defecation, shortness of breath, etc. to diseases of certain organs. However, it is not the case. If any symptoms of a convulsive syndrome are found, it is necessary to be examined by a surgeon, therapist, neurosurgeon, neuropathologist and psychologist. Based on the information collected, specialists will draw up a general picture of the state of human health and determine the possible causes of seizures.

At the same time, it is very important not to delay going to the hospital, since tonic convulsions can happen at any time and at the most inopportune moment. The most dangerous situation is when such problems occur in the respiratory system.

Children

Convulsions in children begin with a wandering look. The child quickly loses contact with the outside world. The symptom continues with the throwing of the head back, already known to us. Also, the child can involuntarily straighten-bend his legs and arms, close his jaws. Outwardly, the baby may turn pale dramatically.

Children are more prone to seizures, since their brain is still immature, the excitability of the nervous system is low. Under the influence of infections and toxins that enter weak vessels, convulsions can occur. Children's seizures are divided into epileptic and non-epileptic. Sometimes the latter can transform into the former. Seizures can also be a consequence of the vaccine.

newborns

In newborns, the febrile form of the syndrome is most common. It is accompanied by high body temperature, observed not only in infants, but also in children under 5 years of age. Febrile convulsions most often go away with age and do not bring much inconvenience.

Premature babies are most susceptible to tonic convulsions. The syndrome may be accompanied by vomiting, regurgitation, cyanosis, and impaired breathing. Duration about 20 minutes. Very often, tonic convulsions in newborns are associated with asphyxia and birth injuries. Asphyxia causes swelling of the brain, resulting in petechial hemorrhages. In this case, immediate help from doctors is needed, as brain atrophy may begin. Seizures in children can occur as a result of traumatic brain injuries during childbirth. There are also local tonic convulsions (on the face, hands, etc.), which disappear after the baby is taken out of the womb.

Seizures with stuttering

Tonic convulsions during stuttering bring great discomfort to the child. They are a spasm that lasts for a long time and prevents the child from talking. 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 speech of the child in this case resembles a conversation in the cold, resembling a shiver.

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

Treatment

Treating tonic seizures is not an easy task even for an experienced specialist. Professional medical help for convulsions is a must. The doctor must determine the cause of their occurrence and prescribe treatment. While the patient is taking tests to find the cause, he is prescribed drugs to normalize pressure and sedatives. In emergency cases, use drugs aimed at stopping seizures.

Treatment has three goals: maintaining vital functions for the body, getting rid of seizures and reducing

At the same time, one should not ignore such traditional medicine as tinctures and ointments. Radical measures should not be taken, but it will be useful to support the body and calm the nervous system with decoctions of herbs. Herbs such as clover, mistletoe, rhubarb leaves, sweet clover, and chamomile are excellent for relieving symptoms.

Urgent care

An attack of tonic convulsions can happen at the most inopportune time. That is why it is very important to know how to help a person in such a situation, because a spasm of the respiratory system may occur, which is deadly. The first thing to do is call the doctors. Only then should you start providing first aid. It is very important to provide a person with an influx of oxygen, so it is advisable to open windows, place a person closer to a source of fresh air. This will avoid oxygen starvation, as well as a number of negative consequences that arise because of this. If the person is dressed too warmly and the clothes are too tight, you may need to undress them a bit to ease the spasm. It is important to take care that a person does not damage his tongue during a seizure. To do this, place a folded towel or handkerchief in your mouth.

The person should lie on their side, as there is a possibility of vomiting. The position on the side will avoid possible suffocation by vomit. Put something soft under your head.

help yourself

Sometimes a person has to provide first aid to himself even through pain, if no one is around. If a generalized cramp has occurred, that is, one that has spread to the whole body, you will have to wait for outside help. If the cramp is local, then self-massage should be performed. It should be short-lived, but the impact must be firm. If a person is prone to seizures, you should always have a needle with you to prick a certain part of the body and relieve tension.

Preventive measures

Sometimes seizures are the result of a serious illness or injury. However, involuntary contraction of the muscles of the arm, for example, may be the result of an indifferent attitude towards one's health. To prevent the occurrence of seizures, it is very important to give the whole body feasible and regular exercise. Sport is the best prevention. Especially experts recommend jogging. Equally important is the diet, which should not contain too much junk or fatty foods. You should also exclude coffee, alcohol and tobacco from your diet.

Summing up the results of the article, I would like to say that the health of each person is in his own hands. Lead a healthy lifestyle, eat the right foods, and get out in the fresh air. Equally important is the advice to be less nervous and not worry about trifling reasons.

Clonic seizures are involuntary rhythmic contractions of skeletal muscles. Unlike tonic (constant muscle contraction), they alternate with relaxation pauses. The duration and frequency of development of a convulsive syndrome over a period of time (in neurology, the accepted interval is 5 minutes) depend on the causes of the pathology. During an attack, both individual muscles and their groups are able to contract.

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The mechanism of development of seizures

The share of diseases occurring with convulsions accounts for up to 70-80% of all neurological pathologies. In all other areas of medicine, this figure ranges from 5-15%.

Convulsive muscle contraction is associated with the work of their sacromeres. This is the name of the areas of muscle cells containing fibrillar proteins: actin and myosin.

Normally, they cause contraction with the help of calcium ions under the action of a nerve impulse. Muscle cramp develops by the following mechanisms:

• violation of the receipt of a nerve impulse;
• excess calcium ions;
• simultaneous excess of calcium and violation of the impulse (mixed mechanism).



Causes and types

The causes of seizures are classified as follows:

• Central. Twitching develops as a result of pathological activity of muscle neurons. Its foci are localized in the brain. For example, this occurs in newborns with birth injuries, with suffocation by the umbilical cord, or in adults and children against the background of skull injuries.
• peripheral causes. The occurrence of seizure activity is associated with a violation in the neuromuscular junctions or changes in the concentration of calcium.

The central causes are leading for all neurological pathologies that occur with convulsions. The first is epilepsy. It can be of various origins: idiopathic (without specification) or secondary (after a traumatic brain injury, surgery in the cranial cavity, brain tumors, meningitis, encephalitis).

A large group of diseases of the internal organs can lead to brain damage. This is a cardiac pathology (malformations, rhythm disturbances, arterial hypertension, kidney and liver diseases). Especially relevant is eclampsia in pregnant women, since a convulsive syndrome can develop in a matter of minutes and lead to rapid death or intracranial hemorrhage. This condition includes contractions that occur in response to spasms of the vessels of the head.

Peripheral disorders leading to clonic and tonic seizures are as follows:

• infections (tetanus, cholera);
• calcium metabolism disorders (parathyroid disease, rickets);
• organophosphate poisoning.

There are the following types of seizures:

• clonic (rhythmic contraction, alternating with breaks);
• tonic (without pauses).

According to the prevalence, local and generalized involuntary contractions are distinguished.



Clinical picture

Symptoms depend on the specific disease. Sometimes it is a pronounced attack, covering all the muscles of the body.

In another case, it can be expressed by twitching a certain area.



Epilepsy

The classic convulsive syndrome is observed during an epileptic attack. It begins with clonic twitching of the muscles of the limbs and torso. There are tonic convulsions in the neck. After a few seconds, the amplitude of contractions increases, tonic convulsions on the trunk join. The patient begins to move involuntarily with the whole body.

The nature of muscle contractions changes almost instantly. Therefore, in epilepsy, convulsions are mixed - they are tonic-clonic. During the attack, the patient is unconscious. After the end of the convulsions, the patient does not immediately come to his senses. Some patients are in prostration, gradually remembering all the events preceding the attack. Patients never remember convulsions themselves. An important circumstance in epilepsy is that patients bite their tongue (if assistance is not started in time), they have involuntary urination. The state after seizures depends on the stage of the disease.

Peripheral pathologies

The contractions in this case are clonic-tonic and cover the entire body. The patient is unconscious during the attack. The amplitude of muscle twitches can rarely be the same as in epilepsy. Most often, it is lower and differs in a certain constancy. The tongue is rarely bitten. Urination is not observed. The exit from the attack occurs through a longer period of stupor and apathy. The events preceding the convulsions are remembered with difficulty. Sometimes patients have amnesia for several days.

If convulsions occur against the background of progressive diseases of the kidneys, liver, or are complicated by hemorrhage, the patient does not regain consciousness after an attack. The severity of seizures and the amplitude of twitching depend on the stage of the disease.

Infections and poisoning

The patient is conscious, but often it is clouded. Clonic-tonic twitches are rare. Most often, the patient develops muscle tone of the body. The duration of the attack depends on the stage of the disease and its severity. Seizures rarely go away without special medical intervention. Due to the fact that the patient is conscious, he feels pain.

Local myoclonus is sometimes possible. It is characteristic of cholera in neurological patients.

Calcium metabolism disorders

The classic seizure never occurs. The patient is always conscious. Tonic contractions occur 10 times more often than clonic ones.

Cramps rarely cover all muscle groups. They are most often found on the limbs. The syndrome is always preceded by a period of illness. Anticonvulsants are ineffective.

Diseases of the subcortical structures of the brain

Seizures are characterized by local muscle twitches. They are found in diseases united in the group of hyperkinesias. All pathologies are divided according to the nature of seizures, their prevalence and severity. United due to the fact that they are associated with disorders in the limbic system (subcortical nuclei responsible for conducting nerve impulses to the muscles and from skin recipes to the cerebral cortex). With widespread small-amplitude convulsions, they speak of a tremor. The patient cannot control the contractions of the muscles of the body, but is able to maintain a pose and make conscious movements with the limbs. Tremor is also possible for individual muscle groups. An example is myoclonus of the upper extremities. Trembling of the lower ones is less often noted.

Another group of hyperkinesis differs in that the contraction occurs locally, in a certain area of ​​​​the body (muscles on the face or on the legs). In some patients, the lip twitches during a conversation, or there is a spasm of the pharynx and tongue. This is often seen with stuttering. All hyperkinesias have a common feature. Their appearance is always associated with external influences and conscious motor activity. Most often it is psycho-emotional stress.

Complications

Skeletal muscle twitching is usually not life threatening. A person during an epileptic seizure can inflict a traumatic brain injury on himself. It is dangerous for a patient with hyperkinesis to work with electrical appliances and fragile materials, as he is unable to control the strength of his impact, which can cause injury.

Muscle contractions during infections and calcium metabolism disorders are more dangerous. They can spread to the respiratory muscles, resulting in death. Contractions are characterized by duration and severity on the muscles that extend the body.

Myoclonic convulsions also do not pose a threat. Due to the pronounced pain syndrome, they violate the quality of life.

Seizure treatment

Therapy of a convulsive syndrome depends on its causes. The basic drugs that are treated are anticonvulsants:

• tranquilizers (Diazepam, Phenazepam, Nitrazepam and others);
• anticonvulsants (Lamotrigine, Carbomazepine, Depakine-chrono, etc.);
• barbiturates (Phenobarbital, Cyclobarbital, Thiopental).

The use is indicated only for tonic-clonic convulsions and relief of unspecified twitches. For example, with an epileptic seizure. In all other cases, the choice of the drug is carried out individually. With hyperkinesis, Cyclodol, Methyldopa, Dopegyt and other drugs that regulate the production of neurotransmitters are important. Medicines are used to improve the functioning of neurons - Mexidol, Actovegin. With peripheral convulsions, the elimination of the main factor is in the first place. Antibacterial agents are indicated for infection. Treatment for the correction of calcium metabolism is directed to the parathyroid glands.