Grand Mal Seizure : Causes-Symptoms-Diagnosis-Treatment


 What Is Grand Mal Seizure?

A tonic-clonic seizure is a sort of seizure that reasons strong muscle actions on both facets of your frame, including convulsions. These are typically the greatest regarded and easiest to understand seizures due to these movements.

Tonic-clonic seizures were previously known as “grand mal'' seizures, from the French word that means “incredible infection.” The time period “tonic-clonic” refers to the 2 stages of those seizures, with the initial tonic segment concerning vast tensing up of muscle tissues to your legs and arms after which the colonic segment regarding convulsions.

What Is Grand Mal Seizure?
Grand Mal Seizure

A tonic-clonic seizure, also known as a grand mal seizure, causes violent muscle contractions and loss of consciousness. These are the forms of seizures most people realize approximately, and what they generally picture after they reflect on consideration of seizures in standard.

They are the most commonplace form of generalized seizure, or seizure that impacts the entire frame.

The muscle tissues of the arms and legs stiffen at some point of the primary part of the seizure, known as the tonic element. Then, the muscular tissues of the hands, legs and face start to jerk all through the second one phase of the seizure, called the clonic element. Some sufferers may also only experience one part of the seizure. Others may experience each.

Tonic-clonic seizures remain between one and three minutes. Any seizure lasting longer than five mins will want clinical interest.

  1. Musculoskeletal system

Medical terms

  • A grand mal seizure causes a lack of attention and violent muscle contractions. It's the kind of seizure most people photo when they think about seizures.
  • A grand mal seizure — also known as a generalized tonic-clonic seizure — is as a result of atypical electric hobby for the duration of the mind. Usually, a grand mal seizure is because of epilepsy. But every now and then, this type of seizure can be prompted by different health troubles, along with extraordinarily low blood sugar, a high fever or a stroke.
  • Many human beings who have a grand mal seizure by no means have some other one and don't want a remedy. But someone who has recurrent seizures may additionally want treatment with daily anti-seizure medicinal drugs to manipulate and prevent destiny grand mal seizures.

symptoms If you see someone having a seizure don't panic Remember that this is a medical emergency and the person will need immediate medical attention when the seizure is over Stay with the person until the seizure is over even if they are able to talk move or open their eyes during it If they start to choke on their tongue or vomit turn them on their side to help prevent this from happening.

Types of Seizures

Seizures are classified into two groups.

  1. Generalized seizures affect both sides of the brain.

  • Absence seizures, Occasionally called petit mal seizures, can cause rapid blinking or some seconds of staring into an area.

  • Tonic-clonic seizures, also called grand mal seizures, can make a person

    • Cry out.

    • Lose consciousness.

    • Fall to the ground.

    • Have muscle jerks or spasms.

The person may feel tired after a tonic-clonic seizure.

  1. Focal seizures Are positioned in just one area of the brain. These seizures are also referred to as partial seizures.

  • Simple focal seizures Affect a small part of the mind. These seizures can cause twitching or a change in sensation, consisting of an odd taste or smell.

  • Complex focal seizures Can make a person with epilepsy pressured or dazed. The character will not be able to respond to questions or courses for up to three minutes.

  • Secondary generalized seizures Begin in a single part of the mind, however then spread to each facet of the mind. In different phrases, the individual first has a focal seizure, accompanied by means of a generalized seizure.

Is a grand mal seizure an emergency?

It is an emergency Because of the potential for serious harm in a grand mal seizure seek medical care without delay.

How long does it take to recover from a grand mal seizure?

When someone has a grand mal seizure it is called a tonic-clonic seizure It is the most common type of seizure and involves loss of consciousness and body convulsions During this type of seizure the person's back arches and their arms and legs become rigid About 80 percent of seizures are this type After the person regains consciousness following the tonic-clonic phase they will be sleepy and confused for a while In some cases they may not remember what happened during the seizure.

Do grand mal seizures cause brain damage?

Grand mal seizures are the type of seizure that most people think of when they hear the word “seizure.” It involves a sudden loss of consciousness accompanied by jerking movements, often arms and legs. During the attack people are unaware of their surroundings and unable to respond to what is going on around them. These seizures can be violent and last from 30 seconds to two minutes or more.

Many things can trigger epileptic seizures such as lack of sleep or food alcohol or drug use stress and flashing lights The person who is about to have a seizure will feel an aura or strange sensation that warns that an attack may be coming The aura involves seeing flashes of light or feeling tingling in the hands or face Although it's frightening for the person experiencing the aura it's a good warning that the seizure is approaching.

Symptoms Grand mal seizure

Tonic-clonic seizures are commonly what humans consider when they think about seizures and epilepsy.

Grand mal seizures have two stages:

  • Tonic phase. Loss of attention takes place, and the muscular tissues  contract and motive the character to give way. This segment has a tendency to last about 10 to 20 seconds.

  • Clonic phase. The muscle groups cross into rhythmic contractions, alternately flexing and enjoyable. Convulsions normally close one to two minutes or less.

The following signs and signs and symptoms arise in some however not each person with grand mal seizures:

  • A scream. Some people may cry out at the beginning of a seizure.

  • Loss of bowel and bladder control. This may happen during or following a seizure.

  • Unresponsiveness after convulsions. Unconsciousness may additionally persist for numerous minutes after the convulsion has ended.

  • Confusion. A duration of disorientation often follows a grand mal seizure. This is referred to as postictal confusion.

  • Fatigue. Sleepiness is common after a grand mal seizure.

  • Severe headache. Headaches may occur after a grand mal seizure.

When to see a doctor

Seek immediate medical help if any of the following occurs:

  • The seizure lasts more than five minutes

  • Breathing or consciousness doesn't return after the seizure stops

  • A second seizure follows immediately

  • You have a high fever

  • You're experiencing heat exhaustion.

  • You're pregnant.

  • You have diabetes.

  • You've injured yourself during the seizure.

If you experience a seizure for the first time, seek medical advice.

Additionally, seek medical advice for yourself or your child:

  • If the number of seizures experienced increases significantly without explanation

  • If new seizure signs or symptoms appear

Causes Grand mal seizure

Grand mal seizures arise when the electrical activity over the entire surface of the brain turns abnormally synchronized. The mind's nerve cells normally communicate with each other by sending electric and chemical signals across the synapses that join the cells.

In human beings who've seizures, the brain's common electric pastime is altered and lots of nerve cells heat at the same time. Exactly what causes the modifications to arise regularly stays unknown.

However, grand mal seizures are every so often because of underlying fitness issues, which include:

Injury or infection

  • Traumatic head injuries

  • Infections, such as encephalitis or meningitis, or a history of such infections

  • Injury due to a previous lack of oxygen

  • Stroke

Congenital or developmental abnormalities

  • Blood vessel malformations in the brain

  • Genetic syndromes

  • Brain tumors

Metabolic disturbances

  • Very low blood levels of glucose, sodium, calcium or magnesium

Withdrawal syndromes

  • Using or withdrawing from drugs, including alcohol

Risk factors Grand mal seizure

There are numerous hazard factors that increase someone’s probability of getting a seizure.

Risk factors for grand mal seizures include:

  • A family history of seizure disorders

  • Any injury to the brain from trauma, a stroke, previous infection and other causes

  • Sleep deprivation

  • Medical problems that affect electrolyte balance

  • Illicit drug use

  • Heavy alcohol use

Complications Grand Mal Seizure

People regularly have brief forgetfulness, trouble with speech, or problems moving after a seizure. It is likewise greater not unusual for humans to fall and harm themselves or chunk their tongue than for the duration of different types of seizures.

However, it's essential to say that epilepsy does not appreciably shorten a person’s lifestyle expectancy. If someone has another fitness condition, inclusive of heart ailment, it is able to have an effect on their lifestyles expectancy.

Although uncommon, it's far viable that a person might also sustain a lifestyle threatening damage all through a seizure. Additionally, a few seizures can be prolonged. Having a protracted lasting seizure can prevent oxygen from achieving the mind and cause brain harm.

Having a seizure at sure instances can cause occasions which are risky for you or others. You is probably prone to:

  • Falling. If you fall during a seizure, you can injure your head or break a bone.

  • Drowning. If you have a seizure even while swimming or bathing, you are vulnerable to accidental drowning.

  • Car accidents. A seizure that causes both loss of awareness or control can be risky in case you're using a car or operating a different system.

  • Pregnancy complications. Seizures in the course of pregnancy pose dangers to each mom and toddler, and sure anti-epileptic medicinal drugs increase the risk of birth defects. If you have got epilepsy and plan to emerge as pregnant, work with your doctor so that he or she will alter your medications and display your being pregnant, as wished.

  • Emotional health issues. People with seizures are much more likely to have psychological issues, such as depression and anxiety. Problems may be a result of problems coping with the situation itself as well as remedy aspect consequences.

Prevention Grand Mal Seizure

Seizures can manifest to every person below the right occasions, so seizures aren’t completely preventable. However, some humans could have seizures more without difficulty, so that you can take certain proactive steps to lower your danger of them taking place.

The fine things you can do to lessen your danger of getting a seizure consist of:

  • Eat a balanced diet and maintain a healthy weight. Managing your eating regimen can help you keep away from circulatory illnesses and conditions along with stroke, in addition to electrolyte problems (too much or too little sodium, as an instance).

  • Don’t ignore infections. Treating infections reduces the risk of seizures due to contamination or with a high fever related to contamination.

  • Wear safety equipment. Safety gadgets, consisting of a helmet or safety belts or harnesses, assist you to avoid seizures associated with head damage.

  • Don’t abuse alcohol, prescription or recreational drugs. Abusing and retreating from these can each result in seizures. If you have got a dependence on alcohol or any form of drug, your number one care company assists you to find assets and specialized care to help you overcome alcohol or substance abuse.

  • Manage your health conditions. Chronic health situations can regularly reason seizures at once or contribute to different seizure-associated conditions. An instance of this is dealing with your blood sugar when you have Type 1 diabetes or Type 2 diabetes.

  • Avoid possible seizure triggers. People with a record of seizures from flashing lights or other recognised sources ought to use caution and avoid similar triggers whenever feasible.

Diagnosis Grand mal seizure

A particular description of what took place all through your seizure is critical to making a correct diagnosis. Your physician will probably need to talk to a witness who has seen your seizures, as people tend to head unconscious for the duration of grand mal seizures.

The physician will even perform a neurological examination. These examinations observe the muscular tissues, together with reflexes, muscle tone, and energy. They additionally have a look at how you stroll, balance, coordination and posture.

One of the most useful equipment for analysis is an electroencephalogram (EEG). This records electrical interest in the brain. The EEG can record uncommon spikes or waves in electric hobby patterns. Different types of epilepsy may be recognized with these patterns.

Magnetic resonance imaging (MRI) and computed tomography (CT) scans can be used to study the motive and the place within the mind. The scans can display scar tissue, tumors or structural troubles in the brain.

After a seizure, your physician will thoroughly evaluate your signs and symptoms and medical history. Your doctor may also order numerous checks to decide the cause of your seizure and compare how in all likelihood it is that you may have another one.

Tests may include:

  • Neurological exam. Your medical doctor may additionally test your conduct, motor capabilities and intellectual function to decide when you have a problem together with your brain and frightened system.

  • Blood tests. Your medical doctor can also take a blood pattern to check for signs of infections, genetic situations, blood sugar degrees or electrolyte imbalances.

  • Lumbar puncture. If your medical doctor suspects contamination as the purpose of a seizure, you could want to have a pattern of cerebrospinal fluid eliminated for testing.

  • Electroencephalogram (EEG). In this check, docs attach electrodes in your scalp with a paste-like substance. The electrodes report the electrical activity of your mind, which indicates up as wavy strains on an EEG recording. The EEG might also reveal a pattern that tells medical doctors whether or not a seizure is probably to occur once more. EEG testing may assist your medical doctor exclude different conditions that mimic epilepsy as a purpose in your seizure.

  • Computerized tomography (CT) scan. A CT experiment uses X-rays to obtain cross-sectional photos of your brain. CT scans can screen abnormalities for your mind that might cause a seizure, together with tumors, bleeding and cysts.

  • Magnetic resonance imaging (MRI). An MRI makes use of powerful magnets and radio waves to create a detailed view of your mind. Your medical doctor can be capable of hitting lesions or abnormalities in your brain that might cause seizures.

  • Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material injected into a vein to assist visualize lively areas of the mind and detect abnormalities.

  • Single-photon emission computerized tomography (SPECT). A SPECT check makes use of a small quantity of low-dose radioactive cloth that is injected into a vein to create a detailed, three-D map of the blood with the flow interest for your brain that happens at some stage in a seizure. Doctors might also behave in the shape of a SPECT test known as subtraction ictal SPECT coregistered to magnetic resonance imaging (SISCOM), which can also provide even greater-specified effects.

Treatment Grand mal seizure

Tonic-clonic seizures commonly forestall on their own, and there’s no motive to deal with them without delay at the same time as they’re occurring. An exception is if you have reputation epilepticus, that is while a seizure lasts longer than five minutes, otherwise you don’t get better absolutely from a seizure before having another.

The viable remedies related to seizures also rely on what prompted the seizure in the first region. If you had a provoked seizure, treating or curing the underlying situation that caused the seizure should stop the seizures from occurring. If the underlying purpose isn’t curable or treatable, healthcare carriers will try and reduce how regularly your seizures appear or how severe they're.

Healthcare vendors also generally suggest in opposition to treating first-time unprovoked seizures. That’s due to the fact there’s no actuality that some other will show up, which could make remedy useless.

Healthcare companies can use your medical history and tests like EEG, CT experiment or MRI scan to decide if you have a higher chance of getting another seizure.

Not anyone who has one seizure has every other one. Because a seizure can be a remote incident, your physician may not start treatment until you've had multiple. Treatment usually involves the usage of anti-seizure medicinal drugs.


Many medications are used in the treatment of epilepsy and seizures, including:

  • Carbamazepine (Carbatrol, Tegretol, others)

  • Phenytoin (Dilantin, Phenytek)

  • Valproic acid (Depakene)

  • Oxcarbazepine (Oxtellar, Trileptal)

  • Lamotrigine (Lamictal)

  • Gabapentin (Gralise, Neurontin)

  • Topiramate (Topamax)

  • Phenobarbital

  • Zonisamide (Zonegran)

Finding the right medicinal drug and dosage can be difficult. Your health practitioner possibly will first prescribe a single drug at a highly low dosage, after which growth the dosage progressively till your seizures are well-managed.

Many human beings with epilepsy are able to save you from seizures with just one drug, however others want a couple of. If you've attempted  or more single-drug regimens without success, your medical doctor may additionally advocate attempting an aggregate of  tablets.

To achieve the greatest seizure manipulation possible, take medicines exactly as prescribed. Always call your health practitioner before including different prescription medicinal drugs, over the counter tablets or natural remedies. And never stop taking your medicine without speaking to your medical doctor.

Mild side effects of anti-seizure medications can include:

  • Fatigue

  • Dizziness

  • Weight gain

More-troubling facet results that want to be delivered on your doctor's interest immediately include:

  • Mood disruption

  • Skin rashes

  • Loss of coordination

  • Speech problems

  • Extreme fatigue

In addition, the drug Lamictal has been related to an increased danger of aseptic meningitis, an infection of the protective membranes that cover the brain and spinal twine. This is just like bacterial meningitis.

Surgery and other therapies

When anti-seizure medications aren't effective, other treatments may be an option:

  • Surgery. The goal of surgical procedure is to prevent seizures from occurring. Surgeons locate and get rid of the place of your brain in which seizures begin. Surgery works best for people who have seizures that always originate inside the identical area of their brains.

  • Vagus nerve stimulation. A device implanted beneath the skin of your chest stimulates the vagus nerve in your neck, sending alerts in your mind that inhibit seizures. With vagus nerve stimulation, you can nonetheless want to take medicine, however you'll be capable of lowering the dose.

  • Responsive neurostimulation. During responsive neurostimulation, a device implanted at the surface of your mind or within brain tissue can come across seizure pastime and supply an electrical stimulation to the detected area to forestall the seizure.

  • Deep brain stimulation. Doctors implant electrodes within certain areas of your brain to produce electrical impulses that alter strange mind activity. The electrodes connect to a pacemaker-like device placed underneath the pores and skin of your chest, which controls the quantity of stimulation produced.

  • Dietary therapy. Following a weight-reduction plan it truly is high in fat and low in carbohydrates, referred to as a ketogenic weight loss program, and can improve seizure management. Variations on an excessive-fats, low-carbohydrate eating regimen, which include the low glycemic index and modified Atkins diets, although much less effective, are not as restrictive as the ketogenic food regimen and can provide advantage.

Pregnancy and seizures

Women who've had preceding seizures usually are capable of having wholesome pregnancies. Birth defects related to positive medications can occasionally occur.

In particular, valproic acid has been related to cognitive deficits and neural tube defects, together with spina bifida. The American Academy of Neurology recommends that girls avoid the usage of valproic acid at some point of being pregnant due to dangers to the child. It's particularly critical to avoid valproic acid for the duration of the primary trimester of pregnancy, if possible.

Discuss those dangers along with your doctor. Because of the hazard of beginning defects, and because being pregnant can adjust medicine degrees, preconception planning is specifically vital for ladies who have had seizures.

In some instances, it may be suitable to alternate the dose of seizure medication earlier than or all through being pregnant. Medications may be switched in uncommon instances.

Contraception and anti-seizure medications

It's additionally essential to recognise that some anti-seizure medicines can modify the effectiveness of oral contraceptives — a shape of delivery control — and a few oral contraceptives can speed up the absorption of seizure medicinal drugs. If contraception is a high priority, check with your medical doctor to evaluate whether or not your medicinal drug interacts with your oral contraceptive, and if different styles of birth control need to be taken into consideration.

Lifestyle and home remedies

Here are some steps you can take to help with seizure control:

  • Take medication correctly. Don't modify the dosage earlier than speakme for your health practitioner. If you sense your remedy has to be changed, speak it along with your physician.

  • Get enough sleep. Lack of sleep can trigger seizures. Be positive to get good enough relaxation every night time.

  • Wear a medical alert bracelet. This will assist emergency personnel recognize how to deal with you efficiently if you have some other seizure.

Personal safety

Seizures don't commonly bring about serious damage, but if you have recurrent seizures, injury is an opportunity. These steps permit you to avoid injury throughout a seizure:

  • Take care near water. Don't swim alone or relax in a boat without someone nearby.

  • Wear a helmet for protection during activities such as bike riding or sports participation.

  • Take showers instead of baths, unless someone is near you.

  • Modify your furnishings. Pad sharp corners, buy furniture with rounded edges and select chairs that have fingers to maintain you from falling off the chair. Consider carpet with thick padding to guard you in case you do fall.

  • Display seizure first-aid tips In a place wherein human beings can without problems see them. Include any essential phone numbers there, too.

Seizure first aid

It's helpful to recognize what to do if you witness a person having a seizure. If you are liable to having seizures in the future, pass these records alongside to your own family, pals and co-employees in order that they recognize what to do when you have a seizure.

To help someone during a seizure:

  • Carefully roll the person onto one side

  • Place something soft under his or her head

  • Loosen tight neckwear

  • Remove eyeglasses

  • Avoid putting your fingers or other objects in the person's mouth

  • Don't try to restrain someone having a seizure

  • Clear away dangerous objects, if the person is moving

  • Stay with the person until medical personnel arrive

  • Observe the person closely so that you can provide details on what happened

  • Time the seizure

  • Check for a medical alert bracelet or ID

  • Stay calm

Coping and support

If you are dwelling with a seizure disorder, you may experience nerve-racking or careworn approximately what your destiny holds. Stress can have an effect on your mental fitness, so it is crucial to talk along with your health care provider about your feelings and seek methods you could locate to assist.

At home

Your own family can provide a good deal-wanted aid. Tell them what you understand approximately your seizure ailment. Let them recognise they could ask you questions, and be open to conversations approximately their worries. Help them understand your condition via sharing any academic materials or other sources that your health care provider has given you.

At work

Meet together with your supervisor and talk about your seizure ailment and the way it impacts you. Discuss what you want out of your supervisor or co-workers if a seizure occurs even as at work. Consider talking with your co-workers about seizure problems — you can widen your assistance system and bring about reputation and expertise.

You're not alone

Remember, you do not ought to go it by yourself. Reach out to a circle of relatives and pals. Ask your fitness care company about nearby aid agencies or be a part of a web support community. Don't be afraid to ask for assistance. Having a sturdy help device is crucial to living with any medical situation.

  1. Rehabilitation of The Brain and Nerves

Preparing for your appointment

In a few instances, seizures need instantaneous scientific interest, and there may not usually be time to put together for an appointment.

In different instances, your first appointment to evaluate a seizure can be with your family health practitioner or a fashionable practitioner. Or you may mention a specialist, together with a health practitioner trained in brain and anxious gadget conditions (neurologist) or a neurologist trained in epilepsy (epileptologist).

To prepare for your appointment, don't forget what you can do to get ready and recognize what to expect from your medical doctor.

What you can do

  • Record information about the seizure. Include the time, vicinity, signs you experienced and how lengthy it lasted, if you realize this info. Seek input from all and sundry who can also have visible the seizure, along with a member of the family, pal or co-worker, so that you can report facts you may no longer recognise.

  • Write down any symptoms you or your child has experienced, Together with any which can seem unrelated to the purpose for which you scheduled the appointment.

  • Make a list of all medications, Nutrients and dietary supplements you are taking and the dosages used. Also, write down the motives you stopped taking any medications, whether this turned into due to facet consequences or lack of effectiveness.

  • Ask a family member to come with you to the doctor, Because it's not usually clean to not forget the whole thing you've been advised all through your appointment. Also, for the reason that reminiscence loss can happen during seizures, many times an observer is able to better describe the seizure than is the individual that's had the seizure.

  • Write down questions to ask your doctor.

Preparing a listing of questions will assist you make the maximum of a while along with your health practitioner. For a grand mal seizure, a few primary questions to ask your doctor include:

  • Do I have epilepsy?

  • Will I have more seizures?

  • What kinds of tests do I need? Do these tests require any special preparation?

  • What treatments are available and which do you recommend?

  • What types of side effects can I expect from treatment?

  • Are there any alternatives to the primary approach you're suggesting?

  • Is there a generic alternative to the medicine you're prescribing?

  • Do I need to restrict any activities?

  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

Don't hesitate to ask any other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • When did you or your child begin experiencing symptoms?

  • How many seizures have you or your child had?

  • How often do seizures occur? How long do they last?

  • Can you describe a typical seizure?

  • Do the seizures occur in clusters?

  • Do they all look the same, or are there different seizure behaviors you or others have noticed?

  • What medications have you or your child tried? What doses were used?

  • Have you tried combinations of medications?

  • Have you noticed any seizure triggers, such as sleep deprivation or illness?

General summary

  1. A grand mal seizure also known as a generalized tonic-clonic seizure (GTCS) is the most common type of seizure During a grand mal seizure a person's entire body stiffens and then relaxes The person's breathing muscles contract (breathing stops) and may turn bluish There may be foaming at the mouth tongue biting and loss of bladder or bowel control If a grand mal seizure lasts for more than 5 minutes emergency medical help should be called immediately.
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