WordNet

the most important and magnificent in adornment; "grand ballroom"; "grand staircase"
large and impressive in physical size or extent; "the bridge is a grand structure"
informal terms for a mother (同)mama, mamma, mom, momma, mommy, mammy, mum, mummy

PrepTutorEJDIC

『壮大な』;豪壮な / 《名詞の前にのみ用いて》『威厳のある』,気高い / (順位などが)最高の / 重大な,重要な / 《名詞の前にのみ用いて》全体の,全部を合わせた(complete) / 《話》すてきな,すばらしい / 尊大な,うぬぼれた / =grand piano / 《米俗》1,000ドル
《M-》《話》おかあちゃん(mamma)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/05/16 15:05:19」(JST)

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Tonic–clonic seizures (formerly known as grand mal seizures) are a type of generalized seizure that affects the entire brain. Tonic–clonic seizures are the seizure type most commonly associated with epilepsy and seizures in general, though it is a misconception that they are the only type.

Tonic–clonic seizures can be induced deliberately in electroconvulsive therapy.

Pathophysiology

The vast majority of generalized seizures are idiopathic.^[1] However, some generalized seizures start as a smaller seizure such as a simple partial seizure or a complex partial seizure and then spread to both hemispheres of the brain. This is called a secondary generalization.^[2] Factors could include chemical and neurotransmitter imbalances and a genetically determined seizure threshold, both of which have been implicated. The seizure threshold can be altered by fatigue, malnutrition, lack of sleep or rest, hypertension, stress, diabetes, the presence of neon or xenon strobe-flashes, fluorescent lighting, rapid motion or flight, blood sugar imbalances, anxiety, antihistamines and other factors.^[3]

In the case of symptomatic epilepsy, it is often determined by MRI or other neuroimaging techniques that there is some degree of damage to a large number of neurons.^[4] The lesions (i.e., scar tissue) caused by the loss of these neurons can result in groups of neurons forming a seizire 'focus' area, episodically firing abnormally, creating a seizure if the focus is not abolished or suppressed via anti-convulsant drugs.

Phases

A tonic–clonic seizure comprises two phases, the tonic phase and the clonic phase.

Tonic phase: The patient will quickly lose consciousness (though not all generalized tonic-clonic seizures involve a full loss of consciousness), and the skeletal muscles will suddenly tense, often causing the extremities to be pulled towards the body or rigidly pushed away from it, which will cause the patient to fall if standing or sitting. The tonic phase is usually the shortest part of the seizure, usually lasting only a few seconds. The patient may also express brief vocalizations like a loud moan upon entering the beginning seizure with the tonic stage, due to air forcefully expelled from the lungs.

Clonic phase: The patient's muscles will start to contract and relax rapidly, causing convulsions. These may range from exaggerated twitches of the limbs to violent shaking or vibrating of the stiffened extremities. The patient may roll and stretch as the seizure spreads. The eyes typically roll back or close and the tongue often suffers bruising or crushing injuries sustained by strong jaw contractions if the patient does not prepare for the seizure by biting down on -for example- a leather belt or cloth. The lips or extremities may turn slightly bluish (cyanosis) and incontinence is seen in some cases.

Due to physical, mental and nervous exhaustion, postictal sleep with stertorous breathing invariably follows a tonic–clonic seizure. Confusion and total amnesia upon regaining consciousness is usually experienced and slowly wears off as the patient becomes gradually aware that a seizure occurred and remembers who and what he is and where he is. Occasionally the patient may vomit or burst into tears from the experienced mental trauma. An additional smaller seizure can occur several minutes after the main seizure, particularly if the patient's seizure threshold has been brought unusually low by known factors or combinations of such - for example severe hangovers, sleep deprivation, prolonged physical tiredness or caffeine.

References

^ David Y Ko (5 April 2007). "Tonic–Clonic Seizures". eMedicine. Retrieved 2008-03-19.
^ "Epilepsy Action: Simple Partial Seizures". Epilepsy Action. British Epilepsy Association. 19 February 2008. Retrieved 2008-03-19.
^ "Seizure Mechanisms and Threshold". Epilepsy Foundation. Retrieved 2015-11-13.
^ Ruben Kuzniecky, M.D. (16 April 2004). "Looking at the Brain". epilepsy.com. Epilepsy Therapy Project. Archived from the original on 2007-10-12. Retrieved 2008-03-19.

External links

Generalised tonic-clonic seizure at DMOZ

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 成人に生じる初回痙攣発作の評価とマネージメント evaluation and management of the first seizure in adults
2. 小児における痙攣およびてんかん：分類、病因、および臨床的特徴 seizures and epilepsy in children classification etiology and clinical features
3. 成人におけるてんかんのマネージメントの概要 overview of the management of epilepsy in adults
4. Benzodiazepine use disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis
5. 光線力学的治療 photodynamic therapy

English Journal

Epileptic seizure-induced structural and functional changes in rat femur and tibia bone tissues: a Fourier transform infrared imaging study.

Garip S, Sahin D, Severcan F.SourceMiddle East Technical University, Department of Biochemistry, 06531 Ankara, Turkey.
Journal of biomedical optics.J Biomed Opt.2013 Nov;18(11):111409. doi: 10.1117/1.JBO.18.11.111409.
The disease- and drug-related bone disorders are rapidly increasing in the population. It is previously reported that anti-epileptic drugs (AEDs) may cause osteopenia, osteoporosis, and fractures in epilepsy patients. However, it cannot be determined whether the bone disorders in epileptic patients
PMID 23887385

Whole mitochondrial DNA variations in hippocampal surgical specimens and blood samples with high-throughput sequencing: A case of mesial temporal lobe epilepsy with hippocampal sclerosis.

Azakli H, Gurses C, Arikan M, Aydoseli A, Aras Y, Sencer A, Gokyigit A, Bilgic B, Ustek D.SourceDepartment of Genetics, Institute for Experimental Medicine, Istanbul University, Istanbul, Turkey.
Gene.Gene.2013 Oct 15;529(1):190-4. doi: 10.1016/j.gene.2013.06.077. Epub 2013 Jul 18.
INTRODUCTION: Hippocampal sclerosis is the most common lesion in patients with mesial temporal lobe epilepsy. Recently, there has been growing evidence on the involvement of mitochondria also in sporadic forms of epilepsy. In addition, it has been increasingly argued that mitochondrial dysfunction h
PMID 23872536

Proline-induced changes in acetylcholinesterase activity and gene expression in zebrafish brain: Reversal by antipsychotic drugs.

Savio LE, Vuaden FC, Kist LW, Pereira TC, Rosemberg DB, Bogo MR, Bonan CD, Wyse AT.SourceLaboratório de Neuroproteção e Doenças Metabólicas, Programa de Pós-Graduação em Bioquímica, Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600-Anexo, 90035-003 Porto Alegre, RS, Brazil.
Neuroscience.Neuroscience.2013 Oct 10;250:121-8. doi: 10.1016/j.neuroscience.2013.07.004. Epub 2013 Jul 16.
Hyperprolinemia is an inherited disorder of proline metabolism and hyperprolinemic patients can present neurological manifestations, such as seizures, cognitive dysfunctions, and schizoaffective disorders. However, the mechanisms related to these symptoms are still unclear. In the present study, we
PMID 23867765

Japanese Journal

Intraparenchymal Meningioma in a Child : Case Report

SHIMBO Daisuke,KATO Tsutomu,TAKEDA Makoto,IKEDA Hitoshi
Neurologia medico-chirurgica = 神経外科 51(11), 793-797, 2011-11-15
… A 10-year-old boy presented with an intraparenchymal meningioma, which had no attachment to the dura, manifesting as grand-mal seizure. …
NAID 10030030481

起立性調節障害の合併により診断に苦慮した覚醒時大発作てんかんの1例

藤田貴子,井上貴仁,中村紀子 [他],井原由紀子,友納優子,二之宮信也,井手口博,安元佐和,廣瀬伸一
福岡大学医学紀要 36(4), 231-234, 2009-12-00
NAID 110007376603

ロピバカインによる腕神経叢ブロック後,全身痙攣を来した1症例

市川学,石山忠彦,渋谷和広 [他]
麻酔 58(4), 467-469, 2009-04-00
NAID 40016603921

Related Pictures

★リンクテーブル★

リンク元	「てんかん」「大発作」「強直間代発作」
拡張検索	「grand mal convulsion」「grand mal seizure disorder」「grand mal epilepsy」
関連記事	「grand」「males」

「てんかん」

Tonic–clonic seizure
Classification and external resources
Specialty	Neurology
ICD-10	G40.3
ICD-9-CM	345.3
MedlinePlus	000695
eMedicine	neuro/376
MeSH	D004830
	[edit on Wikidata]