Grand mal seizure
Grand mal seizure
A grand mal seizure — also known as a tonic-clonic seizure — features a loss of consciousness and violent muscle contractions. It's the type of seizure most people picture when they think about seizures in general.
Grand mal seizure is caused by abnormal electrical activity throughout the brain. In some cases, this type of seizure is triggered by other health problems, such as extremely low blood sugar or a stroke. However, most of the time grand mal seizure is caused by epilepsy.
Many people who have a grand mal seizure will never have another one. However, some people need daily anti-seizure medications to control grand mal seizure.
Grand mal seizures have two stages.
The following signs and symptoms occur in some but not all people with grand mal seizures.
When to see a doctor
A grand mal seizure lasting more than five minutes, or immediately followed by a second seizure, should be considered a medical emergency in most people. If this happens, emergency care should be sought as quickly as possible.
Additionally, seek medical advice for you or your child:
Grand mal seizures occur when the electrical activity over the whole surface of the brain becomes abnormally synchronized. In general, seizures are caused by abnormal, rhythmic nerve cell (neuron) activity in the brain. The brain's nerve cells normally communicate with each other by sending electrical and chemical signals across the synapses that connect the cells. In people who have seizures, the brain's usual electrical activity is altered.
Exactly what causes the changes to occur remains unknown in about half the cases. However, grand mal seizures are sometimes caused by underlying health problems, such as:
Risk factors for grand mal seizures include:
Certain activities could be dangerous if you have a seizure while doing them. Activities include:
The force of a seizure or falling as a result of a seizure can cause injury. In extreme cases, seizures can be fatal, particularly if medication is not taken consistently or properly.
Types of injuries that can occur with seizures include:
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, you'll probably be referred to a doctor who specializes in nervous system disorders (neurologist).
It's good to be prepared for your appointment. Here's some information to help you get ready for your appointment, and to know what to expect from your doctor.
What you can do
Preparing a list of questions will help you make the most of your time with your doctor. For grand mal seizure, some basic questions to ask your doctor include:
Don't hesitate to ask any other questions that occur to you.
What to expect from your doctor
Tests and diagnosis
He or she may also ask questions to assess your thinking, judgment and memory.
Blood tests and scans
Your doctor may also suggest scans or tests designed to detect abnormalities within the brain.
Treatments and drugs
Not everyone who has one seizure will have another one, and because a seizure can be an isolated incident, your doctor may decide to not start treatment until you've had more than one. Treatment usually involves the use of anti-seizure medications.
Finding the right medication and dosage can be challenging. Your doctor likely will first prescribe a single drug at a relatively low dosage, and then increase the dosage gradually until your seizures are well controlled. Many people with epilepsy are able to prevent seizures by taking only one drug, but others require more than one.
If you've tried two or more single-drug regimens without success, your doctor may recommend trying a combination of two drugs.
To achieve the best seizure control possible, take medications exactly as prescribed. Always call your doctor before adding other prescription medications, over-the-counter drugs or herbal remedies. And never stop taking your medication without talking to your doctor.
Mild side effects of anti-seizure medications can include:
More-troubling side effects that need to be brought to your doctor's attention immediately include:
In addition, the drug Lamictal has been linked to an increased risk of aseptic meningitis, an inflammation of the protective membranes that cover the brain and spinal that's similar to bacterial meningitis.
Pregnancy and seizures
Discuss these risks with your doctor. Because of the risk of birth defects, and because pregnancy can alter medication levels, preconception planning is particularly important for women who've had seizures. In some cases it may be appropriate to change the dose of seizure medication before or during pregnancy. Medications may be switched in rare cases.
Contraception and anti-seizure medications
Lifestyle and home remedies
If you have a seizure disorder, wear a medical bracelet to help emergency medical personnel. The bracelet should state whom to contact in an emergency, what medications you use and what drugs you're allergic to.
Coping and support
Even after they're under control, seizures can affect your life. Grand mal seizures can be frightening to those around you. Children may get teased or be embarrassed by their condition, and both children and adults may be frustrated by living with the constant threat of another seizure. Poor self-esteem, depression and suicide are increased in people who have repeated seizures. Most states restrict those who've had seizures from driving until they've gone a long time without a seizure. Even recreational activities can be affected, because you can't do certain activities, such as swimming, alone.
You may find it helpful to talk with other people who are in the same situation you are. Besides offering support, they may also have advice or tips for coping that you'd never considered. The Epilepsy Foundation has a network of support groups, as well as online forums, for teens and adults who have seizures and for parents of children who have seizures. You can reach the Epilepsy Foundation at 800-332-1000 or through its website. You can also ask your doctor if he or she knows of any support groups in your area.
Last Updated: 2011-06-23
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