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,...


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


Audiogenic seizures


Audiogenic kindling




Brainstem reticular formation


Cyclic adenosine monophosphate


Conditional multi-receptive


Deep layers of superior colliculus


Genetically epilepsy-prone rats


Inferior colliculus


Medial geniculate body


Periaqueductal gray


Post-tonic generalized clonus


Substantia nigra reticulate


Sudden unexpected death in epilepsy



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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