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.
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.
Why do seizures occur?
Causes of tonic seizures
Prolonged muscle tension occurs against the background of excessive excitability of cerebral structures, in conditions of disruption of the cortical regulation of segmental functions. Very often, neurons are negatively affected by toxic, metabolic factors, and endocrine and metabolic disorders. The causes of tonic seizures are the following conditions:
- Infections
: tetanus, rabies, febrile syndrome. - Electrolyte disturbances
: hypocalcemia, hyperkalemia, hypomagnesemia. - Endocrine disorders
: hyper- and hypoglycemia, hyperinsulinism. - Hereditary metabolic diseases
: amino acid (leucinosis, phenylketonuria), carbohydrate (glycogenosis, galactosemia), lipid (Gaucher disease, Norman-Wood disease). - Cardiovascular pathology
: complete atrioventricular block, acute hypotension. - Renal and liver failure
: uremia, bilirubin encephalopathy. - Psychogenic disorders
: hyperventilation syndrome, hysteria. - Epileptic syndromes of childhood
: Lennox-Gastaut encephalopathy, Otahara encephalopathy, infantile spasms. - Intoxication
: alcohol, carbon monoxide poisoning, strychnine. - Overdose of drugs
: morphine, antipsychotics. - The effect of physical factors
: severe overheating or hypothermia, electrical injuries, the influence of radiation.
Sometimes painful spasms are of a professional nature, occurring during prolonged muscle tension in stenographers, musicians, and milkmaids. Leg cramps are common among athletes and people whose work involves standing for long periods of time. They are often observed during pregnancy, with vascular pathology of the lower extremities - varicose veins, obliterating atherosclerosis, endarteritis.
Causes of clonic seizures
Pathological impulses that provoke short-term spasms of skeletal muscles are formed in higher cortical centers, the extrapyramidal system or peripheral motor neurons. Some clonic seizures develop due to focal damage to the brain stem or spinal cord due to tumors and strokes. Other causes of such seizures include:
- Focal epileptic seizures
. - Children's infections
: measles, chickenpox, influenza, parainfluenza. - Severe myoclonic epilepsy of infancy (Dravet syndrome)
. - Diffuse damage to gray matter
: Creutzfeldt-Jakob disease, subacute sclerosing panencephalitis. - Neurodegenerative conditions
: Tay-Sachs, Alpers diseases. - Non-progressive encephalopathies
: with Down syndrome, tuberous sclerosis. - Neonatal paroxysms
: “fifth day seizures”, benign familial epilepsy. - Poisoning
: drugs (piperazine, ergotamine), chemicals (formaldehyde, arsenic).
Causes of tonic-clonic seizures
Often in the clinical picture there is a change from tonic convulsive contractions to clonic ones. Generalized mixed seizures are a typical sign of epilepsy and its severe complication - epistatus. The occurrence of paroxysmal electrical activity of brain neurons is caused by a wide range of damaging factors:
- Cerebral pathology
: vascular disorders (CVA, arteriovenous malformations, aneurysms), traumatic brain injuries, tumors. - Infectious diseases
: polio, cholera, neuroinfections (meningitis, encephalitis, abscesses). - Arterial hypertension
: renal eclampsia, convulsive form of hypertensive crisis. - Toxicoses of pregnancy
: eclampsia. - Hereditary pathology
: leukodystrophy. - Intoxication
: nicotinic, narcotic (amphetamine, cocaine), poisoning (organophosphorus compounds, oxalic acid, lead). - Overdose of medications
: caffeine, atropine, amitriptyline, etc.
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.
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.
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.
Epileptic seizure
A seizure in epilepsy, or, as it is also called, status epilepticus, is perhaps the most striking example of what the average person imagines when they mention seizures.
The man suddenly pushes, his body contracts chaotically, incoherent wheezing is heard, foam comes out of the mouth. The picture is terrible, and the situation requires quick medical intervention. Surprisingly, just one intravenous injection quickly brings a person back to life.
What to do? The main task of a witness of status epilepticus is to ensure the safety of the unfortunate person so that he does not accidentally injure himself on surrounding objects. If possible, it is recommended to lay him on a soft surface and turn his head to the side so that vomit and foam do not enter the respiratory tract. Call an ambulance as quickly as possible.
If an attack occurs for the first time, it is very important to undergo a full examination as soon as possible. This may be the onset of one of the neurological diseases or a brain tumor.
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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
Convulsive attacks that impair motor activity and cause severe pain, accompanied by loss of consciousness and/or breathing difficulties, require immediate medical attention.
To determine the causes of seizures, a general and biochemical blood test is performed to determine the electrolyte imbalance. An MRI of the brain shows the presence of hemorrhages or tumors that may cause seizures. EEG is the main method for diagnosing epilepsy, which also causes seizures.
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.
