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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References
https://www.epilepsy.com/
https://www.nhs.uk/conditions/epilepsy/symptoms/
https://www.nhs.uk/conditions/epilepsy/symptoms/