![Seizures are caused by a sudden surge of abnormal electrical activity in the brain, which can be due to many different conditions. Common triggers for tonic seizures may include stress, lack of sleep, waking up, missed medications, drinking alcohol/alcohol withdrawal, some medications, illegal drug use, menstrual cycle or other hormonal changes, and others.](https://images.medicinenet.com/images/article/main_image/seizures-in-children.jpg?output-quality=75)
Seizures happen when there is a sudden surge of abnormal electrical activity in the brain that often affects how a person appears or acts for a short time. In a tonic seizure, muscle tone in the body is greatly increased and muscles become suddenly stiff or tense.
Tonic seizures:
- Usually involve all or most of the brain, and affect both sides of the body
- May occur with a person fully aware or having only a small change in awareness
- Tonic seizures may occur randomly, but in some cases, they can have a trigger. Common triggers for tonic seizures may include:
- Stress
- Lack of sleep
- Waking up
- Missed medications
- Drinking alcohol or alcohol withdrawal
- Some medications, such as diphenhydramine (Benadryl), cold medicines that contain pseudoephedrine, some herbal remedies
- Illegal drug use, such as cocaine or ecstasy
- In women, menstrual cycle or other hormonal changes
- Specific times of day or night
- Not eating well or going a long time without eating
- Dehydration
- Low blood sugar
- Vitamin and mineral deficiencies
- Specific foods that can aggravate seizures
- Excess caffeine
- Flashing bright lights (uncommon)
- Causes of seizures may vary by age.
Causes of seizures in newborns include:
- Malformations of the brain
- Low levels of blood sugar, blood calcium, blood magnesium or other electrolyte problems
- Lack of oxygen during birth
- Problems with metabolism
- Maternal drug use
- Intracranial bleeding
Causes of seizures in infants and young children include:
- Infections
- Fever (febrile seizures)
- Brain tumor (rare)
Causes of seizures in children and adults include:
- Genetics
- Head trauma
- Congenital conditions
- Down's syndrome
- Angelman's syndrome
- Tuberous sclerosis
- Neurofibromatosis
- Progressive brain disease (rare)
Causes of seizures in seniors include:
- Stroke
- Trauma
- Alzheimer's disease
What Are Symptoms of Tonic Seizures?
Symptoms of tonic seizures include:
- Sudden stiffness or tension in the muscles of the arms, legs, or trunk
- Stiffness lasts about 20 seconds
- Usually happens during sleep
- May cause a person to fall if they are standing when a tonic seizure begins
- After the seizure
- Tiredness
- Confusion
How Are Tonic Seizures Diagnosed?
Tests used to diagnose the cause of seizures include:
- Electroencephalogram (EEG) checks for brain wave patterns consistent with seizure activity
- Brain imaging to look for abnormal areas such as a tumor or infection
- Magnetic resonance imaging (MRI) scan
- Computerized tomography (CT) scan
- X-ray
- Blood tests to check for certain medical disorders
- Lumbar puncture (also called a spinal tap)
- Electrocardiogram (EKG) to check the heart
- Sleep testing
What Is the Treatment for Tonic Seizures?
Treatment for seizures usually involves medicines called anti-epileptic drugs (AEDs), such as:
- Brivaracetam
- Cannabidiol oral solution (Epidiolex)
- Carbamazepine (Carbatrol, Epitol, Tegretol, Tegretol XR
- Cenobamate (Xcopri)
- Clobazam (Onfi, Sympazan)
- Clonazepam (Epitril, Klonopin, Rivotril)
- Diazepam nasal
- Diazepam rectal (Diastat)
- Divalproex sodium (Depacon, Depakote, Depakote ER, Epival)
- Eslicarbazepine Acetate (Aptiom)
- Ethosuximide (Zarontin)
- Ezogabine (Potiga)
- Felbamate (Felbatol)
- Fenfluramine
- Gabapentin (Neurontin)
- Lacosamide (Vimpat)
- Lamotrigine (Lamictal)
- Levetiracetam (Keppra, Keppra XR, Roweepra)
- Lorazepam (Ativan)
- Midazolam nasal (Nayzilam)
- Oxcarbazepine (Oxtellar XR, Trileptal)
- Perampanel (Fycompa)
- Phenobarbital
- Phenytoin (Dilantin, Epanutin, Phenytek)
- Pregabalin (Lyrica)
- Primidone (Mysoline)
- Rufinamide (Banzel, Inovelon)
- Stiripentol (Diacomit)
- Tiagabine hydrochloride (Gabitril)
- Topiramate (Topamax, Qudexy XR, Trokendi XR)
- Valproic Acid (Convulex, Depakene, Depakine, Orfiril, Valporal, Valprosid)
- Vigabatrin (Sabril)
- Zonisamide (Zonegran)
Other treatments for tonic seizures include:
- Diet therapy
- Ketogenic diet
- Modified Atkins Diet
- Low glycemic index diet
- Epilepsy surgery
- Removal of a small part of the brain that's causing the seizures
- Implantation of a small electrical device inside the body to help control seizures (neuromodulation)
- Vagus nerve stimulation (VNS Therapy),
- Responsive neurostimulation (RNS Therapy)
- Deep brain stimulation
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https://www.nhs.uk/conditions/epilepsy/symptoms/