Different Types of Generalized Onset Seizures
These seizures affect both sides of the brain or groups of cells on both sides of the brain at the same time. Generalized onset seizures include types such as tonic-clonic, absence, or atonic to name a few.
This type of seizure is what most people think of when they hear the word “seizure.” An older term for this type of seizure is “grand mal.” As implied by the name, they combine the characteristics of tonic and clonic seizures. Tonic means stiffening, and clonic means rhythmical jerking.
- The tonic phase comes first.
- All the muscles stiffen.
- Air being forced past the vocal cords causes a cry or groan.
- The person loses consciousness and falls to the floor.
- A person may bite their tongue or inside of their cheek. If this happens, saliva may look a bit bloody.
- After the tonic phase comes the clonic phase.
- The arms and legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees.
- After a few minutes, the jerking slows and stops.
An absence seizure causes a short period of “blanking out” or staring into space. You may have heard it referred to as a “petit mal” seizure. Absence seizures usually affect only a person’s awareness of what is going on at that time.
There are two types of absence seizures that may look a bit different. Both types of seizures are short, and people often don’t notice them at first. They may come and go so quickly that no one notices anything wrong. Someone may mistake them for daydreaming or not paying attention.
- Typical Absence Seizures: These seizures are the most common, and they can be hard to catch as they usually last less than 10 seconds. Someone experiencing a typical absence seizure stops all activity. It may look like they are staring off into space or just has a blank look. There may be some subtle movements like fluttering eyelids or eyes turning upwards.
- Atypical Absence Seizures: These are called atypical because they can last up to 20 seconds, have a slower onset and offset, and have different symptoms. Like a typical absence seizure, it may look like the person is staring into space. Other symptoms include changes in muscle tone, fluttering eyelids or blinking, lip smacking or chewing, and hand motions like rubbing fingers together.
Myoclonic seizures are shock-like muscle jerks or twitches. Usually, myoclonic seizures only last a second or two. There can be just one, but sometimes multiple will occur within a short time.
Even people without epilepsy can experience myoclonus in hiccups or in a sudden jerk that may wake you up as you’re just falling asleep. These things are normal and are not seizures. In epilepsy, myoclonic seizures usually cause abnormal movements on both sides of the body at the same time. They occur in a variety of epilepsy syndromes that have different characteristics:
- Juvenile myoclonic epilepsy: The seizures usually involve the neck, shoulders, and upper arms. In many patients, the seizures most often occur soon after waking up. They usually begin around puberty or sometimes in early adulthood. In most cases, these seizures can be well controlled with medication, but it must be continued throughout life. Learn more…
- Lennox-Gastaut syndrome: This is an uncommon syndrome that usually includes other types of seizures as well. It begins in early childhood. These myoclonic seizures usually involve the neck, shoulders, upper arms, and often the face. They may be quite strong and are difficult to control. Learn more…
- Progressive myoclonic epilepsies: This category of rare genetic syndromes feature a combination of myoclonic seizures and tonic-clonic seizures. Treatment is usually not successful for very long, as the seizures cause damage over time. This may include worsening balance, coordination, and cognitive ability. Learn more…
In an atonic seizure, part or all of the body may suddenly become limp. You may have heard these be called “drop seizures” or drop attacks.” These seizures typically last less than 15 seconds and commonly start in childhood.
When an atonic seizure happens, try your best to make sure the person is in a safe place to prevent injuries and falls. If standing, the person often falls to the ground like a ragdoll and could injure themselves. Head protection, such as a helmet or other protective gear, may be needed. If sitting, their head or upper body may slump over. When the seizure starts in just one side of the brain, only parts of the body may be affected.
In some types of epilepsy (like Lennox-Gastaut or Dravet syndrome), seizures can happen in clusters with two or more at a time. If a person is at risk for seizure clusters, they should talk to their doctor or nurse about ways to treat clusters.
Muscle “tone” is the muscle’s normal tension at rest. In a tonic seizure, the tone is greatly increased: the body, arms, or legs become suddenly stiff or tense. They usually last less than 20 seconds, and a person may be aware during these seizures.
Tonic seizures usually happen during sleep and usually involve all or most of the brain, affecting both sides of the body. If they start in one side of the brain, only a part of the body may stiffen. If they start in both sides of the brain, the whole body may stiffen, and the person can fall. Head protection, such as a helmet or other protective gear, may be needed.
Tonic seizures are more common in people who have Lennox-Gastaut syndrome or other syndromes with mixed seizure types. Similarly, these movements may also be seen in other neurological problems too, especially in children.
It is very important to have a written description or video of what happens during a tonic seizure for a neurologist. For example, tonic seizures start suddenly with forceful movements. Events that start more slowly may be due to another condition.
“Clonus” means fast stiffening and relaxing of a muscle that happens repeatedly. In other words, it is repeated jerking. The movements cannot be stopped by restraining or repositioning the arms or legs. Most often, clonic movements are seen as part of a tonic-clonic seizure. They may affect one or both sides of the body, and they only last a few seconds to 1-2 minutes.
Unlike a myoclonic seizure, the jerking in a clonic seizure is more regular and sustained. Clonic and myoclonic seizures can be difficult to distinguish from one another.
Clonic seizures are rare and most commonly occur in babies. In infants, the clonic seizures are very brief and don’t happen very often. In fact, they could possibly go away on their own in a short period of time. If they do not go away, long-term treatment is necessary.
Aina tofauti za mshtuko wa akili: Mashambulizi haya huathiri pande zote mbili za ubongo au makundi ya seli katika pande zote mbili za ubongo wakati huo huo. Mshtuko wa kawaida hutia ndani aina kama vile tonic-clonic, absence, au atonic ili kutaja chache. Aina hii ya mshtuko ni nini watu wengi kufikiri ya wakati wao kusikia neno <unk> mshtuko.<unk> neno la zamani kwa ajili ya aina hii ya mshtuko ni <unk> grand mal<unk> kama inavyoelezwa na jina, wao kuchanganya sifa ya mshtuko tonic na clonic. Tonic humaanisha kuganda, na clonic humaanisha kutikisa kwa mpangilio. - Awamu ya tonic huja kwanza. - Misuli yote huimarika. - Hewa inayosukumwa kupita kwenye kamba za sauti husababisha kilio au kuugua. - Mtu huyo hupoteza fahamu na kuanguka sakafuni. - Mtu aweza kuuma ulimi wake au ndani ya shavu lake. Ikiwa hilo litatokea, mate yanaweza kuonekana kuwa na damu. - Baada ya hatua ya tonic huja hatua ya clonic. - Mikono na miguu huanza kutikisika haraka na kwa mpangilio, ikikunjika na kupumzika kwenye mikono, viuno, na magoti. - Baada ya dakika chache, mshtuko huo hupungua na kukoma. Mshtuko wa kutokuwepo husababisha kipindi kifupi cha "kupoteza fahamu" au kutazama nje. Huenda umesikia ikitajwa kuwa mshtuko wa "petit mal". Kwa kawaida mshtuko wa kutokuwepo huathiri tu ufahamu wa mtu wa kile kinachotokea wakati huo. Kuna aina mbili za mshtuko wa kukosa utunzaji ambao unaweza kuonekana tofauti. Aina zote mbili za mshtuko ni za muda mfupi, na mara nyingi watu hawawaoni mwanzoni. Huenda wakaja na kuondoka upesi sana hivi kwamba hakuna mtu atakayegundua jambo lolote baya. Mtu fulani aweza kuwafikiria kimakosa kuwa wanaota ndoto za mchana au hawaangalii. Mshtuko wa kutokuwepo: Mshtuko huu ni wa kawaida na unaweza kuwa mgumu kukamata kwani kwa kawaida huchukua chini ya sekunde 10. Mtu anayepatwa na mshtuko wa kawaida wa kutokuwepo huacha utendaji wote. Huenda ikaonekana kana kwamba wanatazama nje angani au wanatazama tu bila kuona chochote. Huenda kukawa na harakati fulani zisizo za kawaida kama vile kutikisa paji la macho au macho kuelekeza juu. Matatizo haya ya kutokuwa na kawaida (atypical absence seizures) ni ya kawaida kwa sababu yanaweza kuendelea kwa sekunde 20, na huanza na kuisha polepole na kuwa na dalili tofauti. Kama vile mshtuko wa kawaida wa kutokuwepo, huenda ikaonekana kana kwamba mtu huyo anatazama nje. Dalili nyingine ni mabadiliko katika sauti ya misuli, kutikisa kwa macho au kupiga macho, kupiga midomo au kutafuna, na kufanya harakati za mikono kama vile kutikisa vidole pamoja. Mshtuko wa misuli unaitwa myoclonic seizures na ni mshtuko unaofanana na mshtuko wa misuli. Kwa kawaida, mshtuko wa moyo huendelea kwa sekunde moja au mbili tu. Kunaweza kuwa na moja tu, lakini nyakati nyingine nyingi zitafanyika ndani ya muda mfupi. Hata watu wasio na kifafa wanaweza kupata myoclonus katika hiccups au katika jerk ghafla ambayo inaweza kuamsha wewe kama wewe ni tu kuanguka usingizi. Mambo hayo ni ya kawaida na si mshtuko wa akili. Katika kifafa, mshtuko wa moyo kwa kawaida husababisha miendo isiyo ya kawaida pande zote mbili za mwili wakati uleule. Mshtuko wa kifafa (juvenile myoclonic epilepsy) ni ugonjwa wa kifafa unaosababishwa na sehemu za juu za mikono, shingo na viungo vya mwili. Katika wagonjwa wengi, mara nyingi mshtuko huo hutokea muda mfupi baada ya kuamka. Kwa kawaida huanza karibu na umri wa kubalehe au nyakati nyingine katika umri wa mapema wa watu wazima. Katika visa vingi, mshtuko huo waweza kudhibitiwa vizuri kwa kutumia dawa, lakini lazima uendelee maisha yote. Jifunze zaidi... - Lennox-Gastaut syndrome: Hii ni ugonjwa usio wa kawaida ambao kwa kawaida hutia ndani aina nyingine za mshtuko pia. Inaanza katika utoto wa mapema. Kwa kawaida mshtuko huo huathiri shingo, mabega, mikono, na mara nyingi uso. Huenda zikawa zenye nguvu sana na ni vigumu kuzidhibiti. Jibu: Myoclonic epilepsy ni ugonjwa wa kiini unaosababishwa na ugonjwa wa kiini unaosababishwa na ugonjwa wa kiini. Kwa kawaida matibabu hayafanyi kazi kwa muda mrefu, kwa kuwa mshtuko huo husababisha uharibifu baada ya muda. Hilo laweza kutia ndani kudhoofika kwa usawaziko, utaratibu, na uwezo wa utambuzi. Jibu: Katika mshtuko wa atonia, sehemu ya mwili au mwili wote waweza kuwa dhaifu ghafula. "Hii inaweza kuwa ""drop seizures"" au ""drop attacks"" ambayo huanza wakati wa utotoni." Wakati wa mshtuko wa atonia, jaribu kuhakikisha kwamba mtu huyo yuko mahali salama ili kuzuia majeraha na kuanguka. Ikiwa amesimama, mara nyingi mtu huyo huanguka ardhini kama mwanasesere na anaweza kujeruhiwa. Huenda ikawa lazima uvae kofia ya chuma au vifaa vingine vya kujilinda. Wakiketi, kichwa chao au sehemu ya juu ya mwili wao yaweza kuanguka. Wakati mshtuko huo unapoanza upande mmoja tu wa ubongo, huenda sehemu fulani tu za mwili zikaathiriwa. Katika aina fulani za kifafa (kama vile Lennox-Gastaut au Dravet syndrome), mashambulizi yanaweza kutokea katika makundi na mawili au zaidi kwa wakati mmoja. Ikiwa mtu yuko katika hatari ya kupatwa na makundi ya mshtuko, wanapaswa kuzungumza na daktari wao au muuguzi kuhusu njia za kutibu makundi. Misuli <unk>tone<unk> ni misuli ya kawaida mvutano katika mapumziko. Katika mshtuko wa kiakili, sauti huongezeka sana: mwili, mikono, au miguu huwa migumu au yenye mkazo ghafula. Kwa kawaida, mapigo hayo huchukua muda mfupi kuliko sekunde 20, na mtu anaweza kuwa na ufahamu wakati wa mapigo hayo. Matatizo ya tonic hutokea wakati wa usingizi na kwa kawaida huathiri sehemu zote za ubongo, na kuathiri pande zote mbili za mwili. Ikiwa huanza upande mmoja wa ubongo, sehemu moja tu ya mwili yaweza kuwa ngumu. Ikiwa huanza katika pande zote mbili za ubongo, mwili wote waweza kuwa mgumu, na mtu aweza kuanguka. Huenda ikawa lazima uvae kofia ya chuma au vifaa vingine vya kujilinda. Matatizo ya kifafa ni ya kawaida kwa watu walio na ugonjwa wa Lennox-Gastaut au magonjwa mengine yenye aina mbalimbali za matatizo. Vivyo hivyo, harakati hizo zaweza kuonekana pia katika matatizo mengine ya neva, hasa kwa watoto. Ni muhimu sana kuwa na maelezo ya maandishi au video ya kile kinachotokea wakati wa mshtuko wa tonic kwa mtaalamu wa neva. Kwa mfano, mshtuko wa kiakili huanza ghafula kwa kufanya harakati zenye nguvu. Matukio yanayoanza polepole zaidi yaweza kuwa yanasababishwa na hali nyingine. "Clonus" humaanisha kuganda haraka na kupumzika kwa misuli ambayo hutokea mara kwa mara. Kwa maneno mengine, ni kurudia-rudia-rudia. Harakati hizo haziwezi kukomeshwa kwa kuzuia au kubadilisha msimamo wa mikono au miguu. Mara nyingi, harakati za kloni huonwa kuwa sehemu ya mshtuko wa tonic-clonic. Inaweza kuathiri sehemu moja au zote mbili za mwili na huchukua dakika chache tu. Tofauti na mshtuko wa moyo, mshtuko wa moyo katika mshtuko wa moyo ni wa kawaida na wa kudumu. Huenda ikawa vigumu kutofautisha mshtuko wa kifafa na mshtuko wa kifafa. Matatizo ya clonic ni nadra na hutokea kwa kawaida kwa watoto wachanga. Katika watoto wachanga, mshtuko wa clonic ni mfupi sana na hautokea mara nyingi sana. Kwa kweli, huenda zikaondoka zenyewe kwa muda mfupi. Ikiwa hazitoweki, matibabu ya muda mrefu ni muhimu.