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Pathophysiology of tonic clonic seizure
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PATHOPHYSIOLOGY
Etiology:
Altered integrity of neuron in the
epileptogenic focus
PRECIPITATING FACTORS:
Sensory stimuli: loud noises or bright lights
electrolyte imbalance
PREDISPOSING FACTORS:
Family History
Activated by precipitating factors
Abnormal spontaneous spread electrical
discharges
Partial depolarization
(high voltage electrical discharge)
Partial stimulation of neurotransmitter molecules
Imbalanced release in excitatory and inhibitory neurotransmitters
Lowered seizure threshold
Hyperexcitablity state of neurons in the epileptogenic focus
Spreads to both hemispheres
Clonic phase:
Muscles will contract and relax rapidly
Violent, jerking movements
Upward rolling of the eyeballs
Bowel and urine incontinence in some
cases
Post-ictal phase:
Due to physical and nervous exhaustion, the patient may
have/ will be:
Semiconscious Poor coordination
Mild impairment of fine motor movements Deep sleep Weakness
Hyperexcitability of neurons in the brainstem causing
disruption in the functions of the medulla, pons and
midbrain
Tonic Phase
Disruption in medullary
activity thus alteration in function of
respiratory and cardiovascular
system
Cessation of cardiovascular and respiratory activity causing apnea and
cyanosis.
Alteration in the
activity of the pons.
Musculature stiffening( extremities pulled toward body)
Alteration in the activity in the midbrain (connects
brain to spinal nerves)
Loss of consciousness and swallowing reflex
Inhibitory impulse starts from the thalamus and
interrupts the tonic phase into discontinuous bursts
of electrical activity