All wired up

Andrew and I just got back from our VEEG at the University of Iowa Children's Hospital. Andrew cooperated very well and had a seizure while the resident was making rounds. He then very nicely had another seizure while the neuro was visiting.

Andrew is having what they call tonic seizures with some frequent myoclonics as well. The seizures seem to be provoked by sound about 75% of the time which means there are many times when they just happen out of the blue. Dr Matthews is starting Andrew on a very low dose of Clonazepam (Klonipin) to see if we can get them under control. Our concern is that the seizures are getting longer (up to 40 seconds) and that there is some tonic-clonic activity starting. (Don't know what a tonic seizure is? Scroll to the bottom of this entry).

Anyway, I've got some pictures. This first one is Andrew very happily playing with this wonderful toy they had at the hospital. I was told by the nurse that they get these toys just so we parents must go out and purchase them. LOL This is the same toy that he was playing with when Dr Matthews stopped by and he happily had a very strong tonic seizure. He jerked so hard the toy went flying about 6 feet. I guess this means Andrew only gets plastic, no fine china for him.



This is Andrew all wired up. He hated it when they put those electrodes on. The air gun thing really scared him.


What are tonic seizures?

Tonic Seizures

What are they like?
Here's a typical story: "When Jeff has an episode, he just stiffens up. Both arms are raised over his head and his face has a grimace, as if someone is pulling on his cheeks. If he's standing, he may lose his balance and fall. These seizures don't knock him out like the tonic-clonic seizures, but if he has a few close together, he is often tired."

How long do they last?
Usually less than 20 seconds.

Tell me more
Muscle "tone" is the muscle's normal tension at rest. In a "tonic" seizure, the tone is greatly increased and the body, arms, or legs make sudden stiffening movements. Consciousness is usually preserved. Tonic seizures most often occur during sleep and usually involve all or most of the brain, affecting both sides of the body. If the person is standing when the seizure starts, he or she often will fall.

Who gets them?
They are particularly common in people who have the epilepsy syndrome called Lennox-Gastaut syndrome, but they can occur in anyone.

What's the outlook?
Tonic seizures in Lennox-Gastaut syndrome may become more difficult to control over time. Some patients do achieve a good outcome.

What else could it be?
Children with neurological impairments sometimes make movements that could be mistaken for tonic seizures. The EEG should be able to tell the difference.

How is the diagnosis made?
The EEG can clearly show these seizures if they occur during monitoring.

Topic Editor: Orrin Devinsky, M.D.Last Reviewed:2/11/04