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Tonic Seizures with Clonic recovery symptoms
by AnsharSeraphim, Mar 26, 2008 03:07AM
My girlfriend is going through the diagnosis process for her seizures. I'll try to be as succinct as possible so we can get a little feedback on what seem to be very uncommon symptoms:
Tonic seizure:
During the night she will wake approximately 5 seconds before the seizure and grasp my arm to let me know that one is imminent. When the seizure takes place she will become stiff, extend her right arm at a 90 degree angle (with the right hand curling slightly inward) and her eyes will go to the 2 o'clock position (from the perspective of an observer). She will remain in this position for approximately 15-20 seconds.
A very minor shivering or shaking sensation will start to travel upward from her legs while she is in this position. Once it travels through her torso and neck and reaches her head she will lose consciousness.
She is conscious for these episodes and describes excruciating pain and the feeling of being unraveled or depixelated, sometimes describing pain like she's in a vise or her limbs and body are being corkscrewed. The pain is overwhelming.
Afterwards she is unconscious and her breathing is labored. She salivates and this mixes with the air passing through her lips to create a foam that runs down the side of her face.
Approximately 5 minutes after losing consciousness she will be awake for 6-8 seconds at a time followed by an equal time of unconsciousness. She is receptive to verbal commands at this time, but as she lapses back and forth she will go limp until her next cycle of being conscious. This lasts for 3-5 minutes after which she remains awake and finally speaks with some difficulty. Her words are difficult and usually slurred.
Aura:
She describes a tingling numbness and pulsing sensation in her feet (primarily her left, but it manifests in either) right before having a seizure.
Questions:
1. From what I've read usually Tonic seizures don't have a recovery period like this afterwards or the lapse of consciousness (the articles I've read specify that this usually happens after a clonic seizure). Is this indicative of anything in particular?
2. Is it possible she is experiencing both a tonic and clonic seizure at the same time and that is why she doesn't have the muscle jerking or twitching that I usually read about for such a seizure? (she remains in her initial position with the exception of her right arm extending and doesn't shake or convulse).
3. I've read about somatosensory seizure:
"Other somatosensory features in epilepsy are body image disturbances, such as feeling of movement or altered posture in a stationary limb, feeling of floating, twisting or even disintegration of a body part."
( http://www.e-epilepsy.org.uk/pages/articles/show_article.cfm?id=88 )
This seems to be in line with what she's experiencing. Will there be any difficulties obtaining a diagnosis? (i.e. are seizures in this part of the brain more difficult to record on an EEG?)
Thanks so much for your time and attention in answering these questions,
-Anshar
Tonic seizure:
During the night she will wake approximately 5 seconds before the seizure and grasp my arm to let me know that one is imminent. When the seizure takes place she will become stiff, extend her right arm at a 90 degree angle (with the right hand curling slightly inward) and her eyes will go to the 2 o'clock position (from the perspective of an observer). She will remain in this position for approximately 15-20 seconds.
A very minor shivering or shaking sensation will start to travel upward from her legs while she is in this position. Once it travels through her torso and neck and reaches her head she will lose consciousness.
She is conscious for these episodes and describes excruciating pain and the feeling of being unraveled or depixelated, sometimes describing pain like she's in a vise or her limbs and body are being corkscrewed. The pain is overwhelming.
Afterwards she is unconscious and her breathing is labored. She salivates and this mixes with the air passing through her lips to create a foam that runs down the side of her face.
Approximately 5 minutes after losing consciousness she will be awake for 6-8 seconds at a time followed by an equal time of unconsciousness. She is receptive to verbal commands at this time, but as she lapses back and forth she will go limp until her next cycle of being conscious. This lasts for 3-5 minutes after which she remains awake and finally speaks with some difficulty. Her words are difficult and usually slurred.
Aura:
She describes a tingling numbness and pulsing sensation in her feet (primarily her left, but it manifests in either) right before having a seizure.
Questions:
1. From what I've read usually Tonic seizures don't have a recovery period like this afterwards or the lapse of consciousness (the articles I've read specify that this usually happens after a clonic seizure). Is this indicative of anything in particular?
2. Is it possible she is experiencing both a tonic and clonic seizure at the same time and that is why she doesn't have the muscle jerking or twitching that I usually read about for such a seizure? (she remains in her initial position with the exception of her right arm extending and doesn't shake or convulse).
3. I've read about somatosensory seizure:
"Other somatosensory features in epilepsy are body image disturbances, such as feeling of movement or altered posture in a stationary limb, feeling of floating, twisting or even disintegration of a body part."
( http://www.e-epilepsy.org.uk/pages/articles/show_article.cfm?id=88 )
This seems to be in line with what she's experiencing. Will there be any difficulties obtaining a diagnosis? (i.e. are seizures in this part of the brain more difficult to record on an EEG?)
Thanks so much for your time and attention in answering these questions,
-Anshar
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In somatosensory seizures, the parietal lobe, especially the sensory cortex (post central gyrus) is involved. This area is quite superficial in location and will be picked up easily on the EEG.
I suspect the shaking that she had during the seizure was a mild clonic phase. There is a variable proportion of tonic and clonic movements during a typical "grand mal" seizure.
I do not think she will have a problem in the diagnosis.
Regards