Convulsive Seizures

Convulsion is an episode of abnormal violent and involuntary contraction of the muscle movements. Convulsion rarely last more than a few minutes and are extremely different in their manifestations. They occur when brain cells become too active and disorganized in their electrical properties. The characteristic of the seizures are determined by the site of origin of the abnormal brain discharge and the rapidity and extent to which the discharge spreads throughout the rest of the brain.

Causes of Convulsive seizures: Convulsive seizures occur in a variety of conditions and diseases involving the nervous system and other organs of the body. In some individuals who is experiences recurring seizures the exact nature of the underlying disease is not known, while in others, seizures have been associated with tumors, blood vessel abnormalities, disturbances in brain metabolism, brain scars, and other conditions. Traditionally, the term "epilepsy" is being use to describe the illness suffered by those with recurrent seizures.

Classification of Seizures:

• Grand Mal. Grand mal is one of the most common type of seizure, this type may occur at any age but they usually start before 25. During an attack there is a loss of consciousness, tongue biting, and urinary and fecal incontinence. There is also temporary cessation of breathing which causes bluish tinge of the skin followed by irregular snoring-like breathing. Gradually the patient relaxes, his breathing becomes normal, and he regains consciousness. Afterwards he may be confused, have headaches or gastric disturbances, or fall asleep. The attack may last from less than a minute to 10 minutes, but the post-seizure phrase may last for hours. Grand mal seizures may occur as often as several times a day or as infrequently as once every few years. Sometimes, they occur so close together that the patient does not regain consciousness between attacks.

• Petit Mal. Petit Mal is a different kind of seizure (not a minor form of grand mal). Petit mal attacks usually occur in childhood and rarely persist after the age of 20. This attack is characterized by a sudden brief lapse of consciousness with or without minor movements of the eyes, head, or extremities, there may also be dropping of the head and on occasion, urinary incontinence. The attack lasts from 5 to 30 seconds after which the patient is alert and able to continue his normal activities. Despite their high frequency, attacks rarely occur.
• Psychomotor. Psychomotor seizure is characterized by a change in behavior and perception. Usually there is a clouding of the mind, total amnesia, and automatic movements during an attack. The movements are simple and brief, such as clamping the hands or smacking the lips, but they may also take the form of more complex behavior such as getting out of a chair and walking across a room. Aggressive behavior occasionally occurs, but rarely are violent acts committed. Attacks usually last 2 to 3 minutes and there may be a short of confusion afterward.

• Focal. When the attack is limited to one segment or function of the cerebrum, the term focal itself is applied, manifestations is directly related to the part of the brain involved. The convulsive movements usually begin in a finger and spread to the rest of the hand, the arm, the face, and the leg. If these movements spread to the opposite side of the body, the person loses consciousness and a grand mal attack may occur.
• Minor Motor. In minor motor the attack is brief, it occurs frequently, and lack post seizure abnormalities. This type usually occurs in childhood, but adults may sometimes experience them.

Three common types of minor motor seizure:

1. akinetic seizures - is characterized by a sudden loss of muscle tone. The appearance depends on the muscles affected. "Head bobbing" occurs if the neck loses muscle tone, "bending seizures" occur if the upper extremities are affected, and "drop attacks" occur if the lower extremities are involved.
2. myclonic seizures- are characterized by sudden brief involuntary contraction of the muscles of the trunk or extremities, it may occur singly or repetitively. One type of myoclonic seizure is infantile spasms, which usually occur at about 6 months of age and consist of sudden abduction of the upper extremity and flexion of the hip and knees. Myoclonic seizures may also occur in adolescents with gray matter disease and in adults with viral infections such as encephalitis.
3. massive spasms - are characterized by strong contractions of most of the body's muscles, causing the patient to assume a "jackknife" position, with his arms flung upward, his head forward and down, and his lower limbs pulled up on the trunk. This position may last no longer than 5 to 10 seconds but may be repeated half a dozen times in a few minutes and innumerable times throughout the day.

Diagnosis. Diagnostic tests are essential in determining the exact type of seizure.

• Electroencephalogram is one of the most important tests to determine the type of seizure; it records the brain's electrical activities in the form of waves. It has been found that persons with grand mal, petit mal, and psychomotor seizures have characteristic brain waves.
• Pneumography injection of air into the brain spaces.
• Arteriography injection of dye into the arteries.

Treatment. The treatment of convulsive seizures consists of eliminating the causative factors (if they are known) and administering anticonvulsant drugs. Anticonvulsant drugs supresses the abnormal electrical activity of the brain regardless of the underlying cause. With appropriate treatment, most individuals suffering convulsions are able to lead normal and productive lives.