Types of Seizures
Absence (formerly petite
mal) Typically lasts less than one minute, usually do not fall or become
incontinent, appear to be day-dreaming, often go unrecognized. A patient is
never disoriented afterwards, and
rarely if ever, are ambulances called for this problem.
Tonic Sudden contractions of a muscle group
that last for 10 to 15 seconds. Usually occurs with the upper extremities. Does
not cause a loss of consciousness. Has a poor prognosis as it is usually due to
a structural anomaly.
motions of the muscles, usually in a 30/70 ratio. 30 percent of the time in
contraction, 70 percent of the time in relaxation. Can occur alone but are
usually part of the Tonic-clonic seizure. History from bystanders will help
differentiate between these two.
Tonic-Clonic (formerly grand
mal) Patient may have an aura (visual, auditory, olfactory, somatic) They
may yell out, suddenly stiffen and fall (tonic phase) which lasts for 20 seconds
to 60 seconds and then becomes jerky (clonic phase) The muscle contractions are
typically in a 30/70 ratio and the head and eyes typically deviate to one side
or the other. Bubbly salivation and grunting vocalizations are common as are
incontinence of urine and less commonly, stool.. "Non-electric" seizures rarely
have these findings. Can occur as a result of rapid change in temperature, past head injury, brain tumor or stroke.
When no identifiable cause can be found, it is termed idiopathic seizure or
epilepsy. When the seizure lasts more than 10 minutes, or multiple seizures
occur in succession without regaining cx, you have the diagnosis of status
epileptics which can be treated with Valium or Versed.
muscle contractions occurring in groups of 2-5 usually occurring in the morning
hours or upon waking. There is a genetic trait that can be passed along family
lines that causes myotonic seizures.
Atonic (drop attacks)
Patients without warning will suddenly lose all muscle tone and collapse.
Due to the weight of the head and upper torso, the patient usually falls head first and
should be regarded as a C-Spine injury until proven other wise. Patients usually
regain cx fairly quickly unless an associated head injury occurs. The
differential diagnosis of Stokes-Adams must be also considered as a possibility.
Often, these patient wear helmets for protection.
seizures) A clonic seizure that begins in one area of the body (typically
the hand or foot) and moves progressively towards the other side of the body. It
can be limited to one extremity but can also become grand-mal. It is very very
important to identify the exact location the seizure began i.e. right hand. If
the seizure is limited to only part of the body, cx may be intact.