関: grand mal convulsion、grand mal seizure disorder、tonic-clonic convulsion、tonic-clonic epilepsy

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"
a disorder of the central nervous system characterized by loss of consciousness and convulsions
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
てんかん
《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）』「2015/01/10 21:02:28」(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 are 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 episodically firing abnormally, creating a seizure.

Phases

The seizures are divided into two phases, the tonic phase and the clonic phase, hence the name of the seizure.

Tonic phase: The patient will quickly lose 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 or scream during 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 lacerations sustained by strong jaw contractions. The lips or extremities may turn slightly bluish (cyanosis) and incontinence is seen in some cases.

Due to physical and nervous exhaustion, postictal sleep with stertorous breathing invariably follows a tonic–clonic seizure. Confusion and complete amnesia upon regaining consciousness is usually experienced and slowly wears off as the patient becomes gradually aware that a seizure occurred.

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 2008-03-19.
^ Ruben Kuzniecky, M.D. (16 April 2004). "Looking at the Brain". epilepsy.com. Epilepsy Therapy Project. Retrieved 2008-03-19.

External links

Tonic–clonic seizure at DMOZ

UpToDate Contents

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1. 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
2. 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
3. 乳児や小児の痙攣発作の臨床検査診断 clinical and laboratory diagnosis of seizures in infants and children
4. 小児におけるてんかん症候群 epilepsy syndromes in children
5. 若年性ミオクローヌスてんかん juvenile myoclonic epilepsy

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