I love days when I learn something new...

[RobinN]

Today I learned something that should have been made clear to me. Perhaps I just wasn't listening, or reading carefully. I never understood that a Tonic-Clonic could be broken apart. You can have a Clonic seizure without the Tonic, or vice versa.

I was doing research on bladder control, and why the EMTs always make that a "note" with Rebecca's seizures. I know it "may" occur, but my understanding is that it isn't "always" occurring. When you add up the fact that some people think seizures are "fake" along with misconceptions that everyone looses bladder control with a true Tonic-Clonic seizure.. then it makes the patient even more vulnerable.

So when I was doing research, I found this article that broke the Tonic and the Clonic apart, in addition to the classic Tonic-Clonic.

A. Generalized Seizures are seizures that begin in both halves of the brain.

* Tonic Seizures: patient becomes stiff and may let out a high pitched cry.
* Clonic Seizures: patient falls and may turn blue; arms and legs will jerk rhythmically.
* Tonic-Clonic Seizures: begins with rigidity, may have a sudden fall or cry, followed by muscle jerks (convulsions), shallow breathing or temporarily suspended breathing, bluish skin, and possible loss of bowel or bladder control. The patient is unconscious during seizures that usually last one to two minutes, after which normal breathing resumes. The patient may be confused or tired afterwards and fall into a deep sleep.
* Absence Seizures: these occur most often in children and are characterized by a blank stare; they usually only last a few seconds and may be accompanied by rapid blinking or some chewing mouth movements. The patient is unaware of what is occurring during the seizure, but quickly returns to full awareness afterwards. This may result in learning difficulties if not recognized and treated.
* Myoclonic seizures: sudden brief, massive muscle jerks that may involve the whole body or parts of the body.
* Atonic seizures: (also called “Drop Attacks”) patient suddenly collapses and falls, recovering after 10 seconds to a minute.

I now think that my daughters seizures have been Clonic Seizures. She does not have the typical Tonic addition. Others have made note of how graceful she goes down. As if that is another reason to believe they are not "true" seizures.

Ah, the lack of knowledge is so frustrating. Also the fact that one source will say one thing, and you will find different information elsewhere.
I try to tell those that deal with my daughter that no two seizures are the same. Perhaps this is why some have loss of bladder control and others don't. Perhaps not having the rigid, stiffness of the body, there is no reason to have relaxation with loss of bladder. Just a thought.

Anyone else have only one or the other, Tonic or Clonic, seizure?

[forward2007]

I didn't even know they were two different kinds or parts of a seizure.

[Bernard]

Stacy always has (has had ... knock on wood) the complete tonic clonic variety.

[BuckeyeFan]

The presence of clonic only seizures is a definite possibility. They are technically separate stages/types, though hard to distinguish sometimes as the tonic phase can be very brief.

I refer to mine as tonic clonic basically because that is how they have been described and diagnosed, though never actually recorded and tested while occurring. As far as I know, mine are always preceded by simple and complex partials that are producing the secondary generalized tonic clonic. I say as far as I know because I don't always remember the aura (partial) phase and some have been during my sleep. The last tonic clonic I had was at a festival and a nurse who witnessed it saw me walking in tight circles and new I was seizing before I ever went down. That one was not graceful, because I landed on a tent stake and bruised a couple of ribs.

The lines between simple partial, complex partial, and then the secondarily generalized tonic and clonic phases are very gray and individualized. Even the postictal stage can be confused with the end of the clonic phase.

I can't remember if Rebecca had auras, however your theory is quite plausible. I say had because the longer she goes seizure free, that is a great way to think of them.

I like this link on the different types and the ability to click on each one for more info.

http://www.epilepsyfoundation.org/ab...ypes/index.cfm

You've probably been there, but maybe it will help others understand.

[Dutch mom]

Oh yes Robin, they can be 'broken'; my son has had many different seizures, as well tonic-clonics (grand mals) as 'only' tonics (stiffning cramps) and clonics (jerks.) Futhermore the Lennox Gastaut syndrome came up with asbsences (petit mals), complex partials and atonic drop seizures & head drops. It all started with myoclonics in the beginning and we've seen many new seizure types and patterns developping within 3-4 years.
The ketogenic diet has helped to take the daily seizures away and has improved his EEG from 90-99% continuous activity to < 30%. But in periodes of illness or low ketosis we do still see grand mals, head drops, tonic stiff cramps and absences breaking through.
The tonic stiff cramps sometimes do come with a scary sceam.

[RobinN]

I am told that the ones that are witnessed at school, are not stiff. She doesn't make a sound, she is convulsing and "jerking" but they say is is more a gentle convulsion.
She is out of it, so I know that it is a generalized seizure. She has a headache afterwards, so it is my guess that this would just be the clonic variety. Yet she does complain of muscle aches as well. Guess in the long run it doesn't really matter what it is labeled.

I am sure in a few years they will have new names and new subheadings for each type.

[Bee91]

I have had a tonic seizure by itself. Apparently they are quite strange, since you are as stiff as a board in every single part of your body including your fingers. People who have witnessed the my tonic seizures always say they are always intrigued by them because how long I am stiff.

[BuckeyeFan]

Bee91 - Do you know how long they last? Most of what I have read talks about them being grief (seconds), but without transistioning into a clonic, maybe they last longer. With what I have learned here about E, I am sure anything is possible.

By the way, what happened to the cool shades?

[Bee91]

Yeah....I think they only last a few seconds.

haha! I felt like updating the picture...i think I am going to change it back though...

[brain]

I've had Tonic without the Clonic. And I've had Clonic without
the Tonic. When I had the Wada, in 2006, the Neurosurgeon
informed me I had a Tonic. Now as far as bladder issues, even
though I had bladder surgery that prevents this from happening,
it's very rare I ever loose bladder control at all.

Now with a Tonic-clonic, my (ex) husband, son, friends, and
Medical Personnel - they hardly ever hear me have an 'epileptic
cry', but more of and inhale/exhale brief soft yelp. When my
son was little, he would call it a puppy yelp, but it did not
happen all the time.

The problematic issue is - people read this list of everything
that there is to it an expects that yadda, yadda, yadda, all
has to happen when it does not! NO! I do not bite my tongue
every time I have one, nor do I loose bladder control, but
everything else is there.

Since it happens so quickly, and for a brief moment - there
is absolutely no way to stop it, it just happens. BOOM, BANG,
and then it's over, unless it goes into S.E. (Status Epilepticus)
or turns into back-to-back seizures.

Now to go back into more detailed emphasis:

1) TONIC: for me, I would become rigid, stiff, and in a strange
angle - according to what I've been told my back is thrust
forward and my eyes are either rolled back, wide open, or
wild look, I'm frozen solid. Even my teeth have cracked, chipped,
broken, split, knocked out of socket, from this tremendous force.
Once it's over (without the Clonic) I plop down. I have no
memory of this at all.
When I come out of postictal, my muscles feel like they've all been
pulled to the limits and stretched to the max!
(That's why I've had so much Ben Gay, and it's been a
'joke' about Ben Gay being my other 'boyfriend')

2) CLONIC: for me, can be mistaken for Atonic
(aka Drop Attack) but it's not, I fall suddenly and go into violent
full blown jerking convulsions of contracting muscles, then
go completely lax or limp and can go unconscious for a
moment. Once I come out of postictal ~ I'm pretty much
feeling like I've been shaken up, and had a massive over-
dosage of a major work out. I have no memory of this
at all.

3) TONIC-CLONIC: Same as #1 and #2 above, and
then worse - after postictal, I feel as if I've been
beaten up by a gang with baseball bats (that's the
best illustration I could describe my feeling of it all).
Having no memory of the seizure, I know I had it because of
how my body is feeling. I'm often left in a complete daze,
woozy, drained, and excessively tired; EVEN THOUGH I
HAD ALREADY SLEPT, I have the need to sleep more!
I've also have experienced Todd's Paresis - aka - Todd's
Paralysis which is also followed after a Tonic-Clonic.
Sometimes I don't even realize I've been injured (unless
it was witnessed and I'm already in the hospital) until
after I'm all out of it, as it were last January of this year.

4) CLONIC-TONIC-CLONIC: I only experienced
this several times in my life, it's only been recorded a
couple of times. I've not had this in a very long time.

[Bee91]

yeah...I've only "cried" twice before a tonic clonic seizure

[Dutch mom]

Thank you Brain.
I do recognize your description of the 'single/broken' tonics and the clonics in what I see and feel when my boy has them.
Thank you for adding your feelings because my (handicapped) boy can't tell me. I've learned to interpretate and allmost predict the different types and patterns of his seizures so well, I do know all the signs. But what allways remains, is the question how he experiences them, what does he feel afterwards, what does he remember?

[hawke86]

Very interesting. Most of my seizures are like those mentioned.