Convulsion

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.[1] However, not all epileptic seizures lead to convulsions, and not all convulsions are caused by epileptic seizures.[1] Convulsions are also consistent with an electric shock and improper enriched air scuba diving.[1] Non-epileptic convulsions have no relation with epilepsy, and are caused by non-epileptic seizures.[1]

Convulsion
SpecialtyNeurology, Psychiatry
SymptomsMuscle spasms,[1] uncontrollable shaking[1]
Risk factorsEpilepsy

Convulsion is a common term generally describing uncontrollable muscle contractions.[2] The term convulsion has been used interchangeably with the word "seizure".[2] Seizures may cause a person to have convulsions, but this is not always the case.[2] Convulsion is a type of seizure that involves bursts of electrical activity in the brain.[2] Occasionally the reason for a convulsion is unfamiliar.[2] A convulsion may be caused by illness, a reaction to a medication, or other medical conditions.[2]

The word fit is sometimes used to mean a convulsion or epileptic seizure.[3]

Signs and symptoms

When a person is having a convulsion, they may experience several different symptoms.[1] 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.[4]

Frequent incidence of convulsion in children reduces their true implication.[5]

  • Lack of awareness
  • Loss of consciousness
  • Eyes rolling back
  • 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

Causes

There are numerous conditions that can manifest as a convulsion.[6]

There are few more manifestations that can be the reason for convulsions, including epileptic seizures, febrile seizures, non-epileptic seizures, paroxysmal kinesigenic dyskinesia, and reactions to medication.[2] Various kinds of epileptic seizures are affecting everywhere 60 million people worldwide.[7]

Epileptic seizures

Epilepsy is a neuronal disorder with multifactorial manifestations.[8] It is a noncontagious illness and is usually associated with sudden attacks.[7] Sudden attacks of seizures are an immediate and initial anomaly in the electrical activity of the brain that disrupts the part or whole body.[8] Various areas of the brain can be disturbed by epileptic events.[9] Epileptic seizures can have contrary clinical features.[8] Epileptic seizures can have long-lasting effects on cerebral blood flow (CBF) regulation damage.[10]

Generalized 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.[11][12] Generalized seizures have been broadly classified into two categories: motor and non-motor. [8]

A generalized tonic-clonic seizure (GTCS), is also known as a grand mal seizure.[13][14] It is described as a seizure that has a tonic phase followed by clonic muscle retrenchments.[13] A generalized tonic-clonic seizure is a type of seizure that includes the whole body.[14] Generalized tonic-clonic seizures can happen in people of all ages.[14] (GTCSs) are very hazardous, and they increase the risk of sudden unexpected death in epilepsy (SUDEP) and injuries also.[15] SUDEP is a sudden, unexpected, nontraumatic death in patients with epilepsy.[15] Strong convulsions that are related to GTCSs can also cause falls and severe injuries.[15]

Febrile convulsion

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.[16]

Febrile seizures fall into two categories: simple and complex.[17] 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.[17] A simple febrile seizure is one that is isolated, brief, and generalized.[17] Febrile affects between 2 and 4% of children in the United States and Western Europe, it is the most common childhood seizure.[17] The exact reason for febrile convulsion is unidentified, it might be the outcome of the interchange between environmental and genetic factors.[18] The reason for the fever in febrile convulsion is extra-cranial, and high temperature related to it is a usual functional response to infection.21) [18]

Psychogenic non-Epileptic seizures

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.[2] Psychogenic nonepileptic seizures (PNES) are described as neurobehavioral conditions.[19] PNES is an important differential diagnosis and a common occurrence in epilepsy centers.[20] According to the 5th Edison of Diagnostic and Statistical Manual of Mental Disorders (DSM 5) PNES is classified as a conversion disorder or Functional Neurologic Symptom Disorder characterized by alterations in behavior, motor activity, consciousness, and, sensation.[21] Few neuroimaging (functional and structural) studies suggest that PNES may replicate sensorimotor alterations, emotional regulation, cognitive control, and integration of neural circuits.[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,[23] 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.[5]

Paroxysmal kinesigenic dyskinesia

There is a linkage between infantile convulsion as well as paroxysmal dyskinesia.[24] Paroxysmal kinesigenic dyskinesia (PKD) is characterized by sudden involuntary movement caused by sudden stress or excitement.[25] The relationship between convulsion and PKD is mainly due to the common mechanism of pathophysiology.[24]

Management

In the case of febrile convulsion in children, there may be a need for the treatment of the cause of the fever.[4] There are several first-aid applications that someone can do to help patients with convulsions.[4]

  • Placing the patient on the floor
  • Tapping them onto their side
  • Clearing the area of hard or piercing objects
  • Placing something soft and flat under their head
  • Removing their glasses
  • Loosening or removing anything around their neck [2]

References

  1. MedlinePlus Encyclopedia: Seizures
  2. "Convulsions: Causes, definition, and treatment". www.medicalnewstoday.com. 31 January 2019.
  3. Merriam-Webster: Fit.
  4. "Convulsions Are Different from Seizures: Learn What They Mean". Healthline. 22 March 2019.
  5. 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.
  6. "What is a convulsion?". What is a convulsion? | theindependentbd.com.
  7. 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.
  8. 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.
  9. 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. PMC 7324275. PMID 32561698.
  10. 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.
  11. "Epilepsy Seizure Types and Symptoms". WebMD.
  12. "Grand mal seizure causes". Mayo Clinic.
  13. Kodankandath, Thomas V.; Theodore, Danny; Samanta, Debopam (2022). "Generalized Tonic-Clonic Seizure". StatPearls. StatPearls Publishing. PMID 32119383.
  14. "Generalized tonic-clonic seizure: MedlinePlus Medical Encyclopedia". medlineplus.gov.
  15. Brodovskaya, A; Kapur, J (December 2019). "Circuits generating secondarily generalized seizures". Epilepsy & Behavior. 101 (Pt B): 106474. doi:10.1016/j.yebeh.2019.106474. PMC 6944760. PMID 31431400.
  16. "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.
  17. Shinnar, S; Glauser, TA (January 2002). "Febrile seizures". Journal of Child Neurology. 17 Suppl 1: S44-52. doi:10.1177/08830738020170010601. PMID 11918463. S2CID 11876657.
  18. Paul, SP; Rogers, E; Wilkinson, R; Paul, B (May 2015). "Management of febrile convulsion in children". Emergency Nurse. 23 (2): 18–25. doi:10.7748/en.23.2.18.e1431. PMID 25952398.
  19. 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. PMC 7280483. PMID 32582005.
  20. Asadi-Pooya, AA (June 2017). "Psychogenic nonepileptic seizures: a concise review". Neurological Sciences. 38 (6): 935–940. doi:10.1007/s10072-017-2887-8. PMID 28275874. S2CID 4227746.
  21. 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.
  22. Huff, JS; Murr, N (January 2022). "Psychogenic Nonepileptic Seizures". PMID 28722901. {{cite journal}}: Cite journal requires |journal= (help)
  23. "Definition & Facts for Celiac Disease. What are the complications of celiac disease?". NIDDK. June 2016. Retrieved 26 May 2018.
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  25. Swoboda, KJ; Soong, B; McKenna, C; Brunt, ER; Litt, M; Bale JF, Jr; Ashizawa, T; Bennett, LB; Bowcock, AM; Roach, ES; Gerson, D; Matsuura, T; Heydemann, PT; Nespeca, MP; Jankovic, J; Leppert, M; Ptácek, LJ (25 July 2000). "Paroxysmal kinesigenic dyskinesia and infantile convulsions: clinical and linkage studies". Neurology. 55 (2): 224–30. doi:10.1212/wnl.55.2.224. PMID 10908896. S2CID 5755007.
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