HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Theodore, W. H. Articles by Sato, S. Search for Related Content PubMed PubMed Citation Articles by Theodore, W. H. Articles by Sato, S.

The secondarily generalized tonic-clonic seizure

A videotape analysis

Clinical Epilepsy Section, Epilepsy Research Branch (Drs. Theodore, Porter, Bromfield, Devinsky, and Sato, and K. Kelley), and the Biometry and Field Studies Branch (Dr. Albert), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

We studied 120 generalized tonic-clonic seizures (GTCSs) in 47 patients with video-EEG telemetry. GTCSs were preceded by antecedent seizures, including 13 simple partial, 70 complex partial, 17 simple partial leading to complex partial, seven tonic, seven clonic, and one typical absence. We divided GTCSs into the following phases: onset of generalization, pretonic clonic, tonic, tremulousness, and clonic. The mean GTCS duration was 62 seconds. There was a nonsignificant trend toward longer duration on reduced antiepileptic drug doses. Marked heterogeneity in GTCS phenomenology was present; only 27% of seizures included all five phases. Individual phase duration and clinical expression, including tonic and clonic phases, was highly variable. The clinical phenomena suggest that multiple cortical and subcortical routes of spread may exist. When GTCSs last longer than 2 minutes, intravenous antiepileptic drug treatment should be initiated.

Address correspondence and reprint requests to Dr. William H. Theodore, NIH Building 10, Room 5C-205, Bethesda, MD 20892.

Received November 2, 1993. Accepted in final form February 14, 1994.

This article has been cited by other articles:

				R Surges, A Schulze-Bonhage, and D-M Altenmuller Hippocampal involvement in secondarily generalised seizures of extrahippocampal origin J. Neurol. Neurosurg. Psychiatry, August 1, 2008; 79(8): 924 - 929. [Abstract] [Full Text] [PDF]

				D. J. Costello and A. J. Cole Treatment of Acute Seizures and Status Epilepticus J Intensive Care Med, November 1, 2007; 22(6): 319 - 347. [Abstract] [PDF]

				S. S. Chung, N. C. Wang, and D. M. Treiman Comparative Efficacy and Safety of Antiepileptic Drugs for the Treatment of Status Epilepticus Journal of Pharmacy Practice, April 1, 2007; 20(2): 137 - 146. [Abstract] [PDF]

				R Nandhagopal Generalised convulsive status epilepticus: an overview Postgrad. Med. J., November 1, 2006; 82(973): 723 - 732. [Abstract] [Full Text] [PDF]

				F. Leutmezer, S. Woginger, E. Antoni, B. Seidl, and C. Baumgartner Asymmetric ending of secondarily generalized seizures A lateralizing sign in TLE Neurology, October 22, 2002; 59(8): 1252 - 1254. [Abstract] [Full Text] [PDF]

				D. H. Lowenstein and B. K. Alldredge Status Epilepticus N. Engl. J. Med., April 2, 1998; 338(14): 970 - 976. [Full Text] [PDF]