Convulsion

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Convulsion
Nude woman sitting with artificially induced convulsions (rbm-QP301M8-1887-545) (cropped).jpg
Nude woman sitting with artificially induced convulsions
SpecialtyNeurology, Psychiatry

A convulsion is a medical condition where the body muscles contract and relax rapidly and repeatedly, resulting in uncontrolled shaking.[1] Because epileptic seizures typically include convulsions, the term convulsion is sometimes used as a synonym for seizure. However, not all epileptic seizures lead to convulsions, and not all convulsions are caused by epileptic seizures. Convulsions are also consistent with an electric shock and improper enriched air scuba diving. For non-epileptic convulsions, see non-epileptic seizures.

Convulsive status epilepticus (CSE) is a medical and neurological condition, if treated inappropriately, it may result in death or significant morbidity.[2] Convulsive status epilepticus is defined as more than 30 minutes of either continuous seizure activity or two or more sequential seizures without full recovery of consciousness between seizures.[2] The 30-minute description is built on the extent of convulsive status epilepticus that might lead to unalterable neuronal damage.[2] Furthermost seizures are short-lived, and once a seizure lasts more than five minutes it is likely to be extended.[2]

Convulsion is a common term generally describing uncontrollable muscle contractions.[3] The term convulsion has been used interchangeably with the word “seizure".[3] Seizures may cause a person to have convulsions, but this is not always the case.[3] Convulsion is a type of seizure that involves bursts of electrical activity in the brain.[3] There are many types of seizures, symptoms of which are dependent on where in the brain the seizure is happening.[3] Occasionally the reason for a convulsion is unfamiliar.[3] A convulsion may be caused by illness, a reaction to a medication, or other medical conditions.[3] Convulsion is a condition characterized by violent, uninhibited spasmodic reductions and reductions of the voluntary muscles.[4] Convulsions may be a symptom resulting from various conditions and diseases, such as epilepsy, uremia, eclampsia, rabies, tetanus, strychnine poisoning, and cerebral tumor.[4] The conditions are frequently accompanied by loss of consciousness. These are also caused by the deficiency of vitamin B6 (pyridoxine)[4] During convulsion it is advisable to loosen the individual’s clothing around the neck, the head should be cushioned with a pillow, and any sharp or hard objects should be removed from the area.[4]

The word fit is sometimes used to mean a convulsion or epileptic seizure.[5]

Signs and symptoms[edit]

When a person is having a convulsion, they may experience several different symptoms. These may include: a brief blackout, confusion, drooling, loss of bowel/bladder control, sudden shaking of the entire body, uncontrollable muscle spasms, temporary cessation of breathing, and many more.[1]There are a few more signs and symptoms, which usually last from a few seconds to several minutes, though they can last longer.[6]

  • Lack of awareness, loss of consciousness
  • Eyes rolling back in the head
  • The face that appears red or blue
  • Changes to breathing
  • Stiffening of the arms, legs, or whole body
  • Jerky movements of the arms, legs, body, or head
  • Lack of control over movements
  • Inability to respond[6]

Frequent incidence of convulsion in children reduces their true implication.[7] Convulsions in infancy and childhood are not essentially benign, and when prolonged may result in irreversible damage to the brain, with the production of additional epileptogenic foci and psychomotor retardation.[7] Recurrent headaches or abdominal pain may be the sole manifestation of the convulsive disorder.[7]

Causes of Convulsions[edit]

There are numerous conditions that can manifest as a convulsion, few causes of convulsions include,[8]

  • Severe infection, sepsis (an infection that spreads through the blood)
  • Very high fever
  • Severe vomiting and/or diarrhea
  • Diabetic crisis (extremely high or low blood sugar levels)
  • Hydration abnormalities—severe dehydration or over-hydration
  • Severe malnutrition
  • Excessive blood loss
  • Organ failure
  • Severe allergic reaction
  • Drug overdose
  • Drug withdrawal
  • Heatstroke[8]

There are few more manifestations that can be the reason for convulsions, including Epileptic seizures, Febrile seizures, Non-epileptic seizures, Paroxysmal kinesigenic dyskinesia, Medication reactions.[3] Various kinds of epileptic seizures are affecting everywhere 60 million people worldwide.[9] These conditions may be the reason for extreme changes in the body, that may consequence in a convulsive reaction.[8] Few of the conditions can cause the production of the fluid imbalances, and electrolyte abnormalities which lead to a convulsion.[8]

Epileptic seizures[edit]

Epilepsy is a neuronal disorder with multifactorial manifestations.[10] It is a noncontagious illness and, is usually associated with sudden attacks.[9] Epileptic seizures can be described as abnormal jerky or unsteady movements in the body due to abnormal neuronal action.[10] Sudden attacks of seizures are an immediate and initial anomaly in the electrical activity of the brain that disrupts the part or whole body.[10] It can result in damage to the brain or other parts of the body.[10] It can be the cause of lifelong developmental, cognitive, and motor deficits in the developing brain.[11] Even a single seizure can cause changes in neural development and can lead to behavioral and cognitive changes.[10] Various areas of the brain can be disturbed by epileptic events.[12]Epileptic seizures can have contrary clinical features. [10] The focus of epileptogenic located in the temporal lobe for approximately 33% of epileptic patients, it is referred to as temporal-lobe epilepsy (TLE).[12] Epileptic seizures can have long-lasting effects on cerebral blood flow (CBF) regulation damage.[11] These attacks infrequently aggravate neurocognitive illnesses which can be the reason for severe physical injury to the patient.[9] Additionally, people with epileptic seizures occasionally suffer emotional distress due to awkwardness and lack of suitable social status.[9] Hence, early detection of epileptic seizures can help the patients and improve their quality of life.[9]

Generalized seizures[edit]

Main article: Tonic-clonic seizures

The most common type of seizure is called a generalized seizure, also known as a generalized convulsion. This is characterized by a loss of consciousness which may lead to the person collapsing. The body stiffens for about a minute and then jerks uncontrollably for the next minute. During this, the patient may fall and injure themselves or bite their tongue and lose control of their bladder. A familial history of seizures puts a person at a greater risk for developing them.[13][14] Generalized epilepsies characterized by seizures in which the first clinical appearances specify early participation of both hemispheres.[15] The EEG at the time of onset is bilateral.[15] Some patients have generalized or bilateral ictal appearances such as absences, generalized convulsions, or bilateral myoclonic jerks when visible to stimuli.[15] These seizures are, however, associated with idiopathic generalized epilepsy.[15]Generalized seizures has been broadly classified into two categories, they have been broadly classified into two categories: motor and non-motor. [10] Motor seizures include tonic-clonic seizures, clonic, tonic, myoclonic, myoclonic-tonic-clonic, myotonicatonic, atonic, and epileptic spasms. Non-motor seizures include typical, atypical, myoclonic, and eyelid myoclonia.[10]

  • Generalized Tonic-clonic seizures: GTCS is the most common type of motor seizure seen in patients with epilepsy.[16] A generalized tonic-clonic seizure (GTCS), is also known as a grand mal seizure.[16][17] It is described as a seizure that has a tonic phase followed by clonic muscle retrenchments.[16] A generalized tonic-clonic seizure is a type of seizure that includes the whole body.[17] Generalized tonic-clonic seizures can happen in people of all ages.[17] GTCS arises due to the rapid involvement of the bilateral cortical, subcortical, and brainstem networks of the brain.[16][17] (GTCSs) are very hazardous, and it increase the risk of sudden unexpected death in epilepsy (SUDEP) and injuries also.[18] SUDEP is a sudden, sudden, nontraumatic death in patients with epilepsy.[18].Strong convulsions that are related to GTCSs can also cause falls and severe injuries.[18]

Febrile Convulsion[edit]

see Febrile seizure

Febrile convulsion (FC) is described as a seizure even in infancy and childhood related to a temperature above 38°C, without any indication of intracranial infection.[19] FC is usually benign and self-limiting with a favourable prognosis.[19] FC events are related to intrauterine, metabolic abnormalities, and vaccination-related features.[19]The clinical features of FC in FC comprise febrile confusion, twitching, increased body temperature, breath-holding attacks, and evolving epilepsy syndrome.[19] A febrile seizure can be categorized into two, simple and complex.[20] A complex febrile seizure can be the one with the focal onset and occurs more than once during a febrile illness, it lasts for more than 10 to 15 minutes.[20] A simple febrile seizure is one that is isolated, brief, and generalized.[20] Febrile affects between 2 and 4% of children in the United States and Western Europe, it is the most common childhood seizure.[20]

Psychogenic Non-Epileptic Seizures[edit]

Non-epileptic seizures are described by the physicians as “Psychogenic illnesses” which occur not due to the electrical disturbances in a person’s brain but due to mental and emotional stress.[3] This is the reason non-epileptic seizures are sometimes referred to as Psychogenic non-epileptic seizures.” (PENS).[3] Psychogenic nonepileptic seizures (PNES) are described as neurobehavioral conditions.[21] PENS is an important differential diagnosis and a common occurrence in epilepsy centers.[22] According to the 5th Edison of Diagnostic and Statistical Manual of Mental Disorders (DSM 5) PENS is classified as a conversion disorder or Functional Neurologic Symptom Disorder characterized by alterations in behavior, motor activity, consciousness, and, sensation.[23] Few neuroimaging (functional and structural) studies suggest that PENS may replicate sensorimotor alterations, emotional regulation, cognitive control, and integration of neural circuits.[24] PENS is sometimes associated with sexual abuse, physical abuse or neglect, traumatic brain injury, medical comorbidities, and psychiatric comorbidities.[22] The prevalence of PNES is probably between 1/50,000 and 1/3000, or 2–33 cases per 100,000 people.21) [22]

Convulsions are the result of abnormal electrical activity in the brain. The specific cause is often not clear. Convulsions can be caused by specific chemicals in the blood, as well as infections like meningitis or encephalitis. Other possibilities include celiac disease,[25] head trauma, stroke or lack of oxygen to the brain. Sometimes the convulsion can be caused by genetic defects or brain tumors.[1] Convulsions can also occur when the blood sugar is too low and deficiency of vitamin B6 (pyridoxine).The Pathophysiology of convulsion remains ambiguous.[7] Biochemical and physiological investigations, including the production of epileptogenic foci by means of freezing lesions of the brain or the direct application of penicillin or alumina cream, have resulted in increased knowledge of the basic mechanisms.[7] Fever is the common activating mechanism in a young child.[7] It can activate the latent seizure disorder or may be associated with isolated convulsions.[7]

A common cause of convulsions in children is febrile seizures. In Nigeria, malaria, which can cause sudden, high fevers, is a significant cause of convulsions among children under 5 years of age.[26]

Management[edit]

The management of the convulsions a dependent on the primary causes of the convulsions.[27] If the episode of convulsion occurs due the reason of head trauma, an infection, diabetic crisis, then the treatment would be dependent on the findings.[27] In some cases, patients may also be required to get admitted to hospitals.[27] There are some medicines that can induce convulsion.[27] In that case, a change of that medication or dosage adjustment is required for preventing future occurrences.[27] In the case of febrile convulsion in children, there may be a need for the treatment of the cause of the fever.[6] There are several first-aid applications, that someone can do to help the patients with convulsions.[6]

References[edit]

  1. ^ a b c MedlinePlus Encyclopedia: Seizures
  2. ^ a b c d McTague, A; Martland, T; Appleton, R (10 January 2018). "Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children". The Cochrane Database of Systematic Reviews. 1: CD001905. doi:10.1002/14651858.CD001905.pub3. PMC 6491279. PMID 29320603.
  3. ^ a b c d e f g h i j "Convulsions: Causes, definition, and treatment". www.medicalnewstoday.com. 31 January 2019.
  4. ^ a b c d "convulsion | pathology | Britannica". www.britannica.com.
  5. ^ Merriam-Webster: Fit.
  6. ^ a b c d "Convulsions Are Different from Seizures: Learn What They Mean". Healthline. 22 March 2019.
  7. ^ a b c d e f g Carter, S; Gold, A (8 February 1968). "Convulsions in children". The New England Journal of Medicine. 278 (6): 315–7. doi:10.1056/NEJM196802082780606. PMID 4866891.
  8. ^ a b c d "What is a convulsion?". What is a convulsion? | theindependentbd.com.
  9. ^ a b c d e Shoeibi, A; Khodatars, M; Ghassemi, N; Jafari, M; Moridian, P; Alizadehsani, R; Panahiazar, M; Khozeimeh, F; Zare, A; Hosseini-Nejad, H; Khosravi, A; Atiya, AF; Aminshahidi, D; Hussain, S; Rouhani, M; Nahavandi, S; Acharya, UR (27 May 2021). "Epileptic Seizures Detection Using Deep Learning Techniques: A Review". International Journal of Environmental Research and Public Health. 18 (11). doi:10.3390/ijerph18115780. PMC 8199071. PMID 34072232.
  10. ^ a b c d e f g h Anwar, H; Khan, QU; Nadeem, N; Pervaiz, I; Ali, M; Cheema, FF (12 June 2020). "Epileptic seizures". Discoveries (Craiova, Romania). 8 (2): e110. doi:10.15190/d.2020.7. PMC 7305811. PMID 32577498.
  11. ^ a b Liu, J; Pourcyrous, M; Fedinec, AL; Leffler, CW; Parfenova, H (November 2017). "Preventing harmful effects of epileptic seizures on cerebrovascular functions in newborn pigs: does sex matter?". Pediatric Research. 82 (5): 881–887. doi:10.1038/pr.2017.152. PMC 5645245. PMID 28665933.
  12. ^ a b Moctezuma, LA; Molinas, M (29 August 2019). "Classification of low-density EEG for epileptic seizures by energy and fractal features based on EMD". Journal of biomedical research. 34 (3): 180–190. doi:10.7555/JBR.33.20190009. PMID 32561698.
  13. ^ "Epilepsy Seizure Types and Symptoms". WebMD.
  14. ^ "Grand mal seizure causes". Mayo Clinic.
  15. ^ a b c d Ferlazzo, E; Zifkin, BG; Andermann, E; Andermann, F (April 2005). "Cortical triggers in generalized reflex seizures and epilepsies". Brain : a journal of neurology. 128 (Pt 4): 700–10. doi:10.1093/brain/awh446. PMID 15728654.
  16. ^ a b c d Kodankandath, Thomas V.; Theodore, Danny; Samanta, Debopam (2022). "Generalized Tonic-Clonic Seizure". StatPearls. StatPearls Publishing.
  17. ^ a b c d "Generalized tonic-clonic seizure: MedlinePlus Medical Encyclopedia". medlineplus.gov.
  18. ^ a b c Brodovskaya, A; Kapur, J (December 2019). "Circuits generating secondarily generalized seizures". Epilepsy & behavior : E&B. 101 (Pt B): 106474. doi:10.1016/j.yebeh.2019.106474. PMID 31431400.
  19. ^ a b c d Owusu, BA (18 January 2022). "Perceived causes and diagnosis of febrile convulsion in selected rural contexts in Cape Coast Metropolis, Ghana". BMC pediatrics. 22 (1): 45. doi:10.1186/s12887-022-03106-7. PMID 35042467.
  20. ^ a b c d Shinnar, S; Glauser, TA (January 2002). "Febrile seizures". Journal of child neurology. 17 Suppl 1: S44-52. doi:10.1177/08830738020170010601. PMID 11918463.
  21. ^ Anzellotti, F; Dono, F; Evangelista, G; Di Pietro, M; Carrarini, C; Russo, M; Ferrante, C; Sensi, SL; Onofrj, M (2020). "Psychogenic Non-epileptic Seizures and Pseudo-Refractory Epilepsy, a Management Challenge". Frontiers in neurology. 11: 461. doi:10.3389/fneur.2020.00461. PMID 32582005.
  22. ^ a b c Asadi-Pooya, AA (June 2017). "Psychogenic nonepileptic seizures: a concise review". Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 38 (6): 935–940. doi:10.1007/s10072-017-2887-8. PMID 28275874.
  23. ^ Doss, JL; Plioplys, S (January 2018). "Pediatric Psychogenic Nonepileptic Seizures: A Concise Review". Child and adolescent psychiatric clinics of North America. 27 (1): 53–61. doi:10.1016/j.chc.2017.08.007. PMID 29157502.
  24. ^ Huff, JS; Murr, N (January 2022). "Psychogenic Nonepileptic Seizures". PMID 28722901. {{cite journal}}: Cite journal requires |journal= (help)
  25. ^ "Definition & Facts for Celiac Disease. What are the complications of celiac disease?". NIDDK. June 2016. Retrieved 26 May 2018.
  26. ^ "Management of Convulsion in Children, a Health concern in Nigeria". Public Health Nigeria. October 2018. Archived from the original on 18 October 2018. Retrieved 18 October 2018.
  27. ^ a b c d e Anunobi, Victor (3 February 2020). "Convulsion - Causes, Symptoms and Treatment". Healthtian.

External links[edit]

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