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Generalized Seizures

A generalized seizure is characterized by the involvement of the whole brain. The excessive electrical discharge is widespread and involves both sides of the brain. The seizure may or may not be convulsive. A generalized seizure is further classified as either: absence, tonic-clonic, myoclonic and atonic.

These seizures most often begin in childhood. In many children with absence seizures, the seizures stop during adolescence. This type of seizure results in a blank stare usually lasting less than 10 seconds. The seizure starts and ends abruptly, and awareness is impaired during the seizure. A person may suddenly stop talking without realizing that anything has occurred. Following the seizure, alertness is regained quickly.

These seizures are sometimes misinterpreted as daydreaming or inattentiveness. Rapid blinking may accompany the seizure and the eyes may roll upwards. An individual may experience as many as several hundred absence seizures in a day. Although absence seizures are often outgrown, some individuals with absence seizures may develop tonic-clonic seizures. Absence seizures tend to run in families.

No immediate first aid is necessary but it is important to mention it to the appropriate parties (e.g. parents) to ensure they are aware the seizure has occurred.

Formerly known as grand mal seizures, tonic clonic seizures have two distinct phases. The tonic phase typically involves a crying out or groan, a loss of awareness and a fall as consciousness is lost and muscles stiffen. The second phase, the clonic phase, typically involves a convulsion. There is typically jerking and twitching of the muscles in all four limbs and movements usually involve the entire body.

Urinary or bowel control may be lost and there may be shallow breathing, a bluish or gray skin color, and drooling. The seizure usually lasts from 1-3 minutes and awareness is regained slowly. A post-ictal state often follows a tonic clonic seizure. This may involve fatigue and confusion and the person may experience a severe headache. Often the person will want to sleep.

These seizures may be primary generalized (meaning that the seizure begins on both sides of the brain simultaneously) or they may follow a brief partial seizures (known as secondarily generalized). Although tonic clonic seizures are most often associated with epilepsy, it is not the most common type of seizure. In adults, partial seizures are the most common type experienced.

If you witness a tonic clonic seizure, it is important to keep calm and let the seizure run its course. Ease the person onto the floor and loosen clothing. Remove objects in the immediate area that may harm or injure the person. Turn the person on their side so that saliva can flow from the mouth. Check for medic alert identification. When the person regains consciousness and the seizure ends, help them become reoriented.

If a seizure last more than 6-10 minutes, or if they occur repeatedly, call an ambulance.

A myoclonic seizure results in a sudden jerk of part of the body such as the arm or leg. The person may fall over. The seizures is very brief. People who do not have epilepsy sometimes experience a sudden jerk of the body when they are falling asleep. This is common and is known as benign nocturnal myoclonus. It is not an epilepsy-related seizure. Please obtain help should an individual injure him/herself during a myoclonic seizure.

An atonic seizure is sometimes called a "drop attack". The seizure involves a sudden loss of muscle tone. This can result in the person falling down or almost falling down, dropping objects, or nodding the head involuntarily. Typically these seizures last for a few seconds. There tends to be no warning so the seizures can be dangerous because of injury. Please obtain help should the individual fall and injure him/herself.


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