More About Seizures
Secondarily Generalized Seizures
Seizures of this kind start as a partial seizure—that is, they start in one limited area of the brain. The forms they take vary as much as other partial seizures. But then (sometimes so quickly that the partial seizure is hardly noticed) the seizure spreads throughout the brain, becoming “generalized.” Here’s how a couple of people with epilepsy described their secondarily generalized seizures:
The seizures start with a tingling in my right thumb. In seconds, my thumb starts jerking. Soon, my whole right hand is jerking. I have learned that by rubbing and scratching my forearm I can sometimes stop the seizure. Other times the jerking spreads up my arm. When it reaches my shoulder, I pass out and people tell me that my whole body starts to jerk.
I only get these about once every 4 to 6 weeks. Oddly enough and as strange as it sounds, I can actually “fight off” a full Grand Mal that this type of seizure ALWAYS, ALWAYS, ALWAYS turns into by remaining calm, completely relaxing and letting go of all tension I have on every muscle in my body, and practicing controlled breathing techniques. Then I concentrate on just those muscles and gently flexing and stimulating those muscle groups, very slightly and gently, and messaging and stimulating those muscle groups to get my brain to start firing neurons to break up the seizure pattern before it runs haywire. It actually works quite well. Before I stopped being afraid of the seizure, it always followed its natural progression: twitching foot, twitching leg, twitching side, twitching body -> tonic-clonic, or twitching finger, twitching hand, twitching arm, twitching body -> tonic-clonic. However, once I began to understand that the seizure wasn’t going to kill me and it was nothing to panic over, I began to try these techniques to try to control the seizure and lesson its control over me and it works…85% of the time, that is! The odd thing is that it almost always begins in my right foot or my left hand. When I first got MS, it actually was my left had that started twitching and then my left arm.
Myoclonic Seizures
What are they like? Here’s a typical story: “In the morning, I get these ‘jumps.’ My arms fly up for a second, and I often spill my coffee or drop what I’m holding. Now and then my mouth may shut for a split second. Sometimes I get a few jumps in a row. Once I’ve been up for a few hours, the jumps stop.”
How long do they last? They’re very brief jerks. Usually they don’t last more than a second or two. There can be just one, but sometimes many will occur within a short time.
Tell me more Myoclonic (MY-o-KLON-ik) seizures are brief, shock-like jerks of a muscle or a group of muscles. “Myo” means muscle and “clonus” (KLOH-nus) means rapidly alternating contraction and relaxation—jerking or twitching—of a muscle.
Even people without epilepsy can experience myoclonus in hiccups or in a sudden jerk that may wake you up as you’re just falling asleep. These things are normal.
In epilepsy, myoclonic seizures usually cause abnormal movements on both sides of the body at the same time. They occur in a variety of epilepsy syndromes that have different characteristics:
These are very similar to Simple Partial Motor Seizures except that these cause the muscles to contract quickly, causes large muscle groups to contract in tandem, causes entire limbs to jerk, and generally are limited to the first few hours after waking up in the morning. Myoclonic Seizures involve larger groups of muscles than Simple Partial Motor Seizures do and will do things like cause my ENTIRE arm to suddenly “jump up” or cause my leg to decide that it wants to take an extra step for no reason, whether I’m walking or just sitting still. Simple Partial Motor Seizures just cause a little twitching here and there. Plus, I only get Myoclonic Seizures in the morning after I wake up and they are usually gone by 11:30 or Noon. Myoclonic Seizures are all visible to other people and make me twitch like I have cerebral palsy or something, whereas Simple Partial Motor Seizures are tiny twitches that most people wouldn’t notice or can’t see because the twitching is a group of muscles inside my body.
Tonic-clonic Seizures (Grand Mal)
What are they like? Here’s a typical story from a parent’s view: “These seizures frighten me. They only last a minute or two but it seems like an eternity. I can often tell Heather’s going to have one because she acts cranky and out of sorts. It begins with an unnatural shriek. Then she falls, and every muscle seems to be activated. Her teeth clench. She’s pale, and later she turns slightly bluish. Shortly after she falls, her arms and upper body start to jerk, while her legs remain more or less stiff. This is the longest part of the seizure. Finally it stops and she falls into a deep sleep.”
How long do they last? Generally, 1 to 3 minutes. A tonic-clonic seizure that lasts longer than 5 minutes probably calls for medical help. A seizure that lasts more than 30 minutes, or three seizures without a normal period in between, indicates a dangerous condition called convulsive status epilepticus. This requires emergency treatment.
Tell me more This type is what most people think of when they hear the word “seizure.” An older term for them is “grand mal.” As implied by the name, they combine the characteristics of tonic seizures and clonic seizures. The tonic phase comes first: All the muscles stiffen. Air being forced past the vocal cords causes a cry or groan. The person loses consciousness and falls to the floor. The tongue or cheek may be bitten, so bloody saliva may come from the mouth. The person may turn a bit blue in the face. After the tonic phase comes the clonic phase: The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees. After a few minutes, the jerking slows and stops. Bladder or bowel control sometimes is lost as the body relaxes. Consciousness returns slowly, and the person may be drowsy, confused, agitated, or depressed.
I haven’t had a full-blown one of these in several months, Thank God! These are the Seizures I fear most, as I expect most people who get seizures fear most as well. My first Tonic-clonic Seizure began with a Secondary Generalized Seizure in my Right Foot while I was in the kitchen one morning at the office at Word & Brown. I thought it was just a nervous jerk or some stupid MS thing that would stop in a minute so I was ignoring it and making my coffee. Then my leg started to jerk. I went on making my coffee. Someone else came in and saw my leg jerking around. I laughed and said, “isn’t that freakin hilarious? My leg’s all twitching and flopping around like a fish! Ha! Ha! Ha!” Then it moved up into my hip and began to tighten and become extremely painful and I asked for a chair to sit in. I said I’d be fine, that I just needed to sit for a few minutes and that it would pass. But then it worked its way up my side to my stomach and started causing my guts and stomach to start twitching and the pain in my leg was becoming excruciating and by this time my leg was bouncing around violently. I gave in and said, you better go get Norm. I need Norm. GO FUCKING GET NORM NOW. HELP! Norm came in. He saw me in that chair. I felt unbearable pain by this time and told him to call 911 or he told me he was calling 911. I don’t know what he said to me, but it was calming and that was the last thing I remember. Norm said my head shot back and I got stiff as a board and started spewing foam like the Exorcist and then started flopping like a fish. I don’t remember any of that. The only thing I remember is waking up on a gurney in the ER at St Joe’s all confused, not knowing where I was, who I was, and what was going on! That was my inauguration into the Realm of Seizures. It’s embarrassing, but I was folding panties when I had my last one a couple months ago. LOL!!! (Hey! I do ALL the freakin laundry so piss off you wankers!)
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