http://www.semanticweb.org/rjyy/ontologies/2015/5/ESSO#Tonic_Seizure

Tonic_Seizure

Sustained (> 3 sec) muscle contractions that lead to positioning ILAE 1989 postural (fencing) focal tonic Stiffness Luders 1998 Blume 2001 1.1.1.2.1 Postural: Adoption of a posture that may be bilaterally symmetric or asymmetric (as in a "fencing posture"). Berg 2010 Tonic Location: Left/right/axial/generalized/bilateral asymmetric

Bancaud 1981 To quote Gowers, a tonic seizure is “a rigid, violent muscular contraction, fixing the limbs in some strained position. There is usually deviation of the eyes and of the head toward one side, and this may amount to rotation involving the whole body, (sometimes actually causing the patient to turn around, even two or three times). The features are distorted; the color of the face, unchanged at first, rapidly becomes pale and then flushed and ultimately livid as the fixation of the chest by the spasms stops the movements of respiration. The eyes are open or closed; the conjunctiva is insensitive; the pupils dilate widely as cyanosis comes on. As the spasm continues, it commonly changes in its relative intensity in different parts, causing slight alterations in the position of the limbs.” Tonic axial seizures with extension of head, neck, and trunk may also occur. Absence with tonic components -affect extensor/flexor (a)symmetrically -head drawn backwards -head may tonically draw to one side or another -trunk arch -retropulsion rigid, violent muscular contraction, fixing the limbs in some strained position Tonic Seizure EEG Seizure type Low voltage, fast activity or a fast rhythm of 9-10c/sec or more decreasing in frequency and increasing in amplitude EEG Interictal Expression More or less rhythmic discharges of sharpa nd slow waves, sometimes asymmetrical. Background is often abnormal for age. ILAE 1989 Luders 1998 Tonic Seizure Location: Left/Right/Axial/Generalized/Bilateral Asymmetric Simple, unnatural movements Like Broadman 4&6 stimulation Blume 2001 1.1.1 Tonic: A sustained increase in muscle contractions lasting a few seconds to minutes 1.1.1.2 Postural: Adoption of a posture that may be bilaterally symmetric or asymmetric (as in a "fencing posture"). Engel 2001 Tonic Seizures Asymmetric tonic motor seizures (assoc w/ supp motor) Blume 2003 Tonic Posture Blume 2003 Dystonic posturing should be sought by observation or history-taking, as it almost always occurs in the arm contralateral to seizure origin. Chewing and swallowing may occur. Ictal speech, even if nonsensical suggests involvement of the temporal lobe non dom for language.

http://www.semanticweb.org/rjyy/ontologies/2015/5/ESSO#Torso

http://www.semanticweb.org/rjyy/ontologies/2015/5/ESSO#Blume_2001_II_1.1.1_Tonic

http://www.semanticweb.org/rjyy/ontologies/2015/5/ESSO#Simple_Motor_Seizure

http://www.semanticweb.org/rjyy/ontologies/2015/5/ESSO#Trunk

http://www.semanticweb.org/rjyy/ontologies/2015/5/ESSO#Engel_2001_Tonic_Seizures

http://www.semanticweb.org/rjyy/ontologies/2015/5/ESSO#Luders_1998_2.4.1.2_Tonic_Seizures

http://www.semanticweb.org/rjyy/ontologies/2015/5/ESSO#Generalized_Seizure