TONIC/CLONIC SEIZURES (SYN: Grand mal)
It is the absence of a focal onset which may distinguish this primary generalised seizure from that evolving from a partial seizure.
The epileptic cry must not be confused with a seizure of focal onset. This results from tonic contraction of respiratory muscles with partial closure of vocal cords. The tonic phase is associated with rapid neuronal discharge. The clonic phase begins as neuronal discharge slows.
artefact. 10-14 Hz spike activity may be seen. When the seizure ends, the record may be 'silent' and then gradually —'——f( \J picks up. Slow rhythm may persist ' ™ r for some hours - postictal changes. /Af^gl^
The record between attacks may 'v •
be normal or slow with occasional clinically silent bursts of seizure activity. N
Again, hyperventilation or photic stimulation may bring out abnormalities.
These are characterised by a loss of muscle tone and a sudden fall. Consciousness may only be lost briefly. The EEG shows polyspike activity or low voltage fast activity.
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