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Pathophysiology of Generalized Tonic-Clonic Seizures

  • Carl L. Faingold
  • M. Steven Evans
Reference work entry

Introduction and Definitions

The clinical features of generalized tonic clonic seizures (GTCS) were described in previous Chapters ( Epilepsy with Generalized Tonic-Clonic Seizures Only;  Generalized Tonic-Clonic Seizures). GTCS are a common and dangerous type of seizure, which can be primarily or secondarily generalized. Primary GTCS begin with tonic stiffening, followed by a clonic pattern of rhythmic jerking, followed by a post-ictal phase of altered mental state. The EEG shows generalized spike-wave discharges and high-amplitude polyspikes at all the scalp electrodes ( Epilepsy with Generalized Tonic-Clonic Seizures Only). These findings indicate wide cerebral cortical involvement during GTCS. There is highly suggestive clinical evidence for brainstem involvement in GTCS. Thus, brainstem and/or spinal cord generators can cause various types of convulsive muscular activity, such as the opisthotonos of strychnine poisoning, the tonic stiffening in extension of decerebrate posturing,...

Keywords

Inferior Colliculus Infantile Spasm Generalize Tonic Clonic Seizure Neonatal Seizure Human Epilepsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations

AGS

Audiogenic seizures

AK

Audiogenic kindling

AMG

Amygdala

BRF

Brainstem reticular formation

cAMP

Cyclic adenosine monophosphate

CMR

Conditional multi-receptive

DLSC

Deep layers of superior colliculus

GEPR-9s

Genetically epilepsy-prone rats

IC

Inferior colliculus

MGB

Medial geniculate body

PAG

Periaqueductal gray

PTC

Post-tonic generalized clonus

SNR

Substantia nigra reticulate

SUDEP

Sudden unexpected death in epilepsy

Notes

Acknowledgment

The authors thank Dean K. Naritoku M.D. for his seminal contributions on this topic and Diana Smith for manuscript preparation.

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Copyright information

© Springer-Verlag London Limited 2010

Authors and Affiliations

  • Carl L. Faingold
    • 1
  • M. Steven Evans
    • 2
  1. 1.Departments of Pharmacology and NeurologySouthern Illinois University School of MedicineSpringfieldUSA
  2. 2.Department of NeurologySouthern Illinois University School of MedicineSpringfieldUSA

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