Atonic seizure

An atonic seizure (also called drop seizure, akinetic seizure, astatic seizure, or drop attack) is a type of seizure that consists of partial or complete loss of muscle tone that is caused by temporary alterations in brain function. These seizures are brief – usually less than fifteen seconds.[1] They usually begin in childhood and may persist into adulthood. The seizure itself causes no physical injury, but the loss of control, predominantly in trunk muscles, can result in direct injury from falling. Electroencephalography can be used to confirm diagnosis. It is rare and can be indicative of Lennox–Gastaut syndrome (see Henri Gastaut).[1] Atonic seizures can occur while standing, walking, or sitting, and are often noticeable by a head drop (relaxing of the neck muscles). Head and eyelids may droop, and they may drop anything they were holding. Fall injuries may result in impact to the face or head. As with common epileptic occurrences, no first aid is needed post-seizure, except in the instances where falling injuries have occurred. In some cases, a person may become temporarily paralyzed in part of his or her body. This usually does not last longer than 3 minutes.[2]

Atonic seizure
Other namesAkinetic seizure, astatic seizure
SpecialtyNeurology Edit this on Wikidata

Symptoms

During an atonic seizure, electrical activity in the brain becomes interrupted; the person has a temporary inability to move or speak and loses muscle strength.[3] The seizure start at one part of the brain or the entire brain.[3] It occurs as a result of a period of uncontrolled electrical activity in the brain.[3] It can cause muscle problems, strange behaviors, unusual sensations, and an altered state of awareness.[3]

The symptoms may include:

  • Sudden loss of muscle strength
  • Going limp and falling to the ground
  • Remaining conscious
  • Experiencing a brief loss of consciousness
  • Head nods
  • Drooping eyelids
  • Jerking[1]

The duration of atonic seizures are generally short.[4] . People might feel disorganized after the seizure, especially when lose consciousness.[4] If the seizure happened during some activity, people might fall.[4] This could lead to aftereffects like:

  • Pain
  • Soreness
  • Bruises
  • Serious injury
  • Cuts[4]

Causes

The cause of atonic seizures is often unknown.[1] Some patients have seizures because of changes in their genes.[1] Hyperventilation and flickering lights can trigger seizures.[1] There are two types of atonic seizures: focal and generalized.[5] Focal seizures affect a small area of the brain and lead to muscle weakness in one area of the body.[5] Generalized seizures can begin throughout both halves of the brain.[5] The reason disturbing a more important part of the body.[5] When an atonic seizure involves the entire brain it known as generalized onset atonic seizure.[5] These seizures begin with a sudden drop of the head, trunk, or whole body.[5]

Probable causes include:[6]

Treatment

There is no general treatment for patients with a seizure disorder. Each treatment plan is specifically tailored to the individual patient based on their diagnosis and symptoms. Treatment options may include medical therapy, nerve stimulation, dietary therapy, or surgery, as appropriate. Clinical trials may also be a valuable treatment alternative. Usually, anticonvulsants are given based on other symptoms and / or associated problems. Because the areas of the cerebellum which determine increases and decreases in muscle tone are close together, people experiencing atonic seizures are most likely experiencing myoclonic ones too, at some point. This may play a role in therapy and diagnostic.[7]

One surgical approach, selective posterior callostomy, can greatly decrease instances of drop attacks and improve function and behavior in patients with intellectual disability.[8]

References

  1. "Articles". Cedars-Sinai.
  2. "Atonic Seizures". Epilepsy Foundation. Retrieved 2019-09-13.
  3. "Atonic seizure: Symptoms, causes, and treatments". www.medicalnewstoday.com. 8 June 2021.
  4. "Atonic Seizures: Causes, Symptoms, Diagnosis, Treatment". Healthline. 16 June 2021.
  5. "Atonic seizure: Symptoms, causes, and treatments". www.medicalnewstoday.com. 8 June 2021.
  6. "Atonic Seizures: Causes, Symptoms, Diagnosis, Treatment". Healthline. 16 June 2021.
  7. "Atonic Seizure - Types of Seizures - The Johns Hopkins Epilepsy Center". Archived from the original on 2012-08-16. Retrieved 2012-08-18.
  8. Paglioli, Eliseu; Martins, William Alves; Azambuja, Ney; Portuguez, Mirna; Frigeri, Thomas More; Pinos, Larissa; Saute, Ricardo; Salles, Cora; Hoefel, João Rubião (2016-11-08). "Selective posterior callosotomy for drop attacks: A new approach sparing prefrontal connectivity". Neurology. 87 (19): 1968–1974. doi:10.1212/WNL.0000000000003307. ISSN 1526-632X. PMID 27733569. S2CID 24541945.
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