Convulsions
Convulsions are temporary impairment of the nervous system produced by an abnormal neuronal and thalamus activity, resulting in a sudden and excessive production of nervous stimulation that contracts muscles.
Usually, during a seizure an individual cannot breathe easily and rolls his or her eyes up or sideways, saliva leaks from his or her mouth, and mandibular muscles stiffen resulting in grinding his or her teeth.
Seizures are a common symptom of epilepsy.
Epilepsy is a condition featuring recurring seizures. It can occur with single seizure, clustering seizures (2 or 3 times during one day), or status epilepticus when seizures are continuous.
Yet, epilepsy is not the only cause of convulsions. Seizures can be also due to:
- head injury
- intoxication with drugs
- drug toxicity, for example aminophylline or local anaesthetics
- normal doses of certain drugs that lower the seizure threshold, such as tricyclic antidepressants
- infection, such as encephalitis or meningitis
- fever leading to febrile convulsions
- metabolic disturbances, such as hypoglycaemia, hyponatremia or hypoxiawithdrawal from drugs (anticonvulsants and sedatives such as alcohol, barbiturates, and benzodiazepines)
- space-occupying lesions in the brain (abscesses, tumors)
- seizures during (or shortly after) pregnancy can be a sign of eclampsia
- certain television and video games can trigger photosensitive epilepsy, such as the episode of Pokemon
Seizure types are organized according to whether the source of the seizure within the brain is localized (partial or focal onset seizures) or distributed (generalized seizures). Partial seizures are further divided on the extent to which consciousness is affected (simple partial seizures and complex partial seizures). Simple seizures cause no interruption to consciousness (although they may cause sensory distortions or other sensations), whereas complex seizures interrupt consciousness to varying degrees. This does not necessarily mean that the person experiencing this sort of seizure will fall unconscious (like fainting). For example, a complex partial seizure may involve the unconscious repetition of simple actions, gestures or verbal utterances, or simply a blank stare and apparent unawareness of the occurrence of the seizure, followed by no memory of the seizure. Other patients may report a feeling of tunnel vision or dissociation, which represents a diminishment of awareness without full loss of consciousness.
Generalized seizures are divided according to the effect on the body but all involve loss of consciousness:
- Absence seizures: they involve an interruption to consciousness where the person experiencing the seizure seems to become vacant and unresponsive for a short period of time (usually up to 30 seconds).
- Myoclonic seizures: they involve an extremely brief (< 0.1 second) muscle contraction and can result in jerky movements of muscles or muscle groups.
- Clonic seizures: they are myoclonus that are regularly repeating at a rate typically of 2-3 per second.
- Tonic-clonic seizures: they involve an initial contraction of the muscles (tonic phase) which may involve tongue biting, urinary incontinence and the absence of breathing. This is followed by rhythmic muscle contractions (clonic phase).
- Atonic seizures: they involve the loss of muscle tone, causing the person to fall to the ground. These are sometimes called 'drop attacks' but should be distinguished from similar looking attacks that may occur in narcolepsy or cataplexy.
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