Grand mal seizure

Grand mal seizure: Description, Causes and Risk Factors:Grand mal seizureGrand mal seizure is the most common form found in epilepsy. They can also be brought on by cerebrovascular accidents, meningitis, encephalitis, drug withdrawal, photic stimulation, fatigue and intoxicants. The entire seizure may be broken down into prodromal, preictal, and postitcal phases which last no more than 15 minutes. However, it may take up to 2 hours for normal, preictal cerebral function to return. A grand mal seizure that lasts for hours or days is termed status epilepticus and can lead to death if not managed.In the prodromal phase the patient may exhibit changes that may be evident only to a relative, such as increased anxiety or depression. A patient with a history of seizures may recognize the development of an "aura" consisting of olfactory, visual, gustatory or auditory changes. If the aura is noted by the patient or the dental staff, treatment should be terminated immediately before it progresses to the preictal phase.Exactly what causes the changes to occur remains unknown in about half the cases. However, grand mal seizures are sometimes caused by underlying health problems, such as:Very low blood levels of glucose, sodium, calcium or magnesium.
  • Traumatic head injuries.
  • Using or withdrawing from drugs, including alcohol.
  • Brain tumors.
  • Strokes.
  • Infections, such as encephalitis or meningitis, or history of such infection.
  • Injury due to a previous lack of oxygen.
  • Blood vessel malformations in the brain.
  • Genetic syndromes.
Risk factors for grand mal seizures include:A family history of seizure disorders.
  • Any injury to the brain from trauma, stroke, previous infection and other causes.
  • Sleep deprivation.
  • Medical problems that affect electrolyte balance.
  • Illicit drug use.
  • Heavy alcohol use.
In many cases, the outlook is very good. With proper treatment, up to 70 percent of people with grand mal seizure ultimately become seizure-free for five or more years. Eventually, about 30 percent are able to discontinue medication permanently.Most children with grand mal seizures can lead normal lives, including participating in organized sports, with minimal restrictions.Symptoms:The following signs and symptoms occur in some but not all people with grand mal seizures.Aura. Some people experience a warning feeling (aura) before a grand mal seizure. This warning varies from person-to-person, but may include feeling a sense of unexplained dread, a strange smell or a feeling of numbness.
  • A scream. Some people may cry out at the beginning of a seizure because the muscles around the vocal cords seize, forcing air out.
  • Loss of bowel and bladder control. This may happen during or following a seizure.
  • Unresponsiveness after convulsions. Unconsciousness may persist for several minutes after the convulsion has ended.
  • Confusion. A period of disorientation often follows a grand mal seizure. This is referred to as postictal confusion.
  • Fatigue. Sleepiness is common after a grand mal seizure.
  • Severe headache. Headaches are common but not universal after grand mal seizures.
Diagnosis:Your doctor will ask for a detailed description of the seizure, which is crucial for diagnosis. Because people who have grand mal seizures lose consciousness and do not remember their seizures, the description needs to come from people who have witnessed the seizures. Your doctor may try to determine whether a particular trigger, such as intense exercise, loud music or lack of sleep, preceded your seizure. However, most people have no identifiable or consistent trigger.Your doctor may also suggest scans or tests designed to detect abnormalities within the brain.Electroencephalogram (EEG). An EEG displays the electrical activity of your brain via electrodes affixed to your scalp. People with epilepsy often have changes in their normal pattern of brain waves, even when they are not having a seizure.In some cases, your doctor may recommend video-EEG monitoring, which may require a hospital stay. This allows your doctor to compare — second by second — the behaviors observed during a seizure with your EEG pattern from exactly that same time. This comparison can help your doctor pinpoint the type of seizure disorder you have, which helps to identify the most appropriate treatment options, and it can help make sure that the diagnosis of seizures is correct.
  • Magnetic resonance imaging (MRI). An MRI machine produces detailed images of your brain. Although many people with seizures and epilepsy have normal MRIs, certain MRI abnormalities may provide a clue as to the cause of seizures in some cases.
During the test, you will lie on a padded table that slides into the MRI machine. Your head will be immobilized in a brace, to improve precision. The test is painless, but some people experience claustrophobia inside the MRI machine's close quarters. If you think you may have this problem, inform your doctor.Treatment:There is no known treatment method for any patient with a seizure disorder. Each treatment plan is tailored to the individual patient based on their diagnosis and symptoms. Treatment options may include medical therapy, nerve stimulation, dietary therapy, or surgery as appropriate. Clinical trials may also be a valuable treatment alternative.First aid for grand mal seizure:Stay calm - remain with the person.
  • Time the seizure.
  • Protect from injury - remove any hard objects from the area.
  • Protect the head - place something soft under their head and loosen any tight clothing.
  • Gently roll the person on their side as soon as it is possible to do so and firmly push the angle of the jaw forward to assist with breathing. A person cannot 'swallow their tongue' but the tongue can move back to cause a serious block to breathing.
  • Stay with the person until the seizure ends naturally and calmly talk to the person until the regain consciousness, usually within a few minutes.
  • Reassure the person that they are safe and that you will stay with them while they recover.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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