Generalized tonic clonic (GTC) seizures Generalized tonic clonic seizures are the classic form of childhood epilepsy, having four phases namely a) aura, b) tonic c) clonic d) post-ictal phase.
Aura is a premonitory symptom, that occurs before the onset of seizure. It can be sensory, motor, visceral or autonomic. Only one third of children can describe aura. Aura is followed by tonic phase, in which the skeletal muscles undergo spasm.
Muscular rigidity is the typical feature of antigravity muscles (flexors of the arms and extensors of legs). The duration of tonic phase is about 30 -35 seconds. The child loses his consciousness and falls on the floor. At the time of seizure, face looks pale, eyes are rolled up, and pupils are dilated. Frothing is seen from the mouth and child …show more content…
They are generally genetically determined, self limiting, occur during fever, in the absence of CNS infections. They are called simple, atypical, and benign seizures, usually occur as single seizure within 24 hours of the onset of fever, and lasts for less than 10 minutes.
Majority febrile convulsions are generalized without any postictal stage.
Febrile convulsions are managed by administration of antipyretic drug and/or hydrotherapy. Seizure is controlled by intravenous administration of Diazepam or Midazolam (0.2- 0.3 mg/kg/dose). Children with recurrent febrile convulsions can be treated with Sodium Valporate (10-20 mg/kg/day) or Phenobarbitone (3-5 mg/kg/day).
Parents can be taught to abort the febrile convulsions by administering nasal/ buccal midazolam (0.05 - 0.2 mg/kg) or rectal diazepam ( 0.5 mg/kg) as part of domiciliary treatment of convulsions. Feeding tube of 8F size, lubricated with paraffin or xylocaine jelly is used (approximately 4cm) for per- rectal administration of diazepam, followed by flush with tap water.
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Aura is a premonitory symptom, that occurs before the onset of seizure. It can be sensory, motor, visceral or autonomic. Only one third of children can describe aura. Aura is followed by tonic phase, in which the skeletal muscles undergo spasm.
Muscular rigidity is the typical feature of antigravity muscles (flexors of the arms and extensors of legs). The duration of tonic phase is about 30 -35 seconds. The child loses his consciousness and falls on the floor. At the time of seizure, face looks pale, eyes are rolled up, and pupils are dilated. Frothing is seen from the mouth and child …show more content…
They are generally genetically determined, self limiting, occur during fever, in the absence of CNS infections. They are called simple, atypical, and benign seizures, usually occur as single seizure within 24 hours of the onset of fever, and lasts for less than 10 minutes.
Majority febrile convulsions are generalized without any postictal stage.
Febrile convulsions are managed by administration of antipyretic drug and/or hydrotherapy. Seizure is controlled by intravenous administration of Diazepam or Midazolam (0.2- 0.3 mg/kg/dose). Children with recurrent febrile convulsions can be treated with Sodium Valporate (10-20 mg/kg/day) or Phenobarbitone (3-5 mg/kg/day).
Parents can be taught to abort the febrile convulsions by administering nasal/ buccal midazolam (0.05 - 0.2 mg/kg) or rectal diazepam ( 0.5 mg/kg) as part of domiciliary treatment of convulsions. Feeding tube of 8F size, lubricated with paraffin or xylocaine jelly is used (approximately 4cm) for per- rectal administration of diazepam, followed by flush with tap water.
5.2.5