eMedicine Specialties > Neurology > Seizures and Epilepsy

Generalized Tonic-Clonic Seizures: Follow-up

Author: David Y Ko, MD, Associate Professor, Department of Neurology, University of Southern California Keck School of Medicine
Coauthor(s): Soma Sahai-Srivastava, MD, Director of Neurology Ambulatory Care Services, LAC and USC Medical Center; Assistant Professor, Department of Neurology, University of Southern California
Contributor Information and Disclosures

Updated: May 6, 2009

Follow-up

Complications

Complications of generalized tonic-clonic seizures include the following:

  • Head trauma and trauma to the tongue, lips, and cheeks
  • Vertebral compression fractures
  • Aspiration pneumonia
  • Neurogenic pulmonary edema
  • Cardiac arrhythmias
  • Sudden death

Patient Education

For excellent patient education resources, visit eMedicine's Brain and Nervous System Center. Also, see eMedicine's patient education article Epilepsy.

Miscellaneous

Medicolegal Pitfalls

  • Certain antiepileptic agents are enzyme inducers and decrease the levels of oral contraceptive agents. Warn patients of this and advise them to use additional contraceptive precaution while on enzyme-inducing medications like phenytoin, carbamazepine, and phenobarbital. 
  • The older first generation AEDs such as phenytoin, carbamazepine, phenobarbital, and valproic acid are all known teratogenic agents.
  • Driving is restricted if patients are still having seizures as per each state laws.
 


More on Generalized Tonic-Clonic Seizures

Overview: Generalized Tonic-Clonic Seizures
Differential Diagnoses & Workup: Generalized Tonic-Clonic Seizures
Treatment & Medication: Generalized Tonic-Clonic Seizures
Follow-up: Generalized Tonic-Clonic Seizures
References

References

  1. Walczak TS, Leppik IE, D'Amelio M, Rarick J, So E, Ahman P, et al. Incidence and risk factors in sudden unexpected death in epilepsy: a prospective cohort study. Neurology. Feb 27 2001;56(4):519-25. [Medline].

  2. Morrell MJ. Differential diagnosis of seizures. Neurol Clin. Nov 1993;11(4):737-54. [Medline].

  3. [Best Evidence] Marson AG, Al-Kharusi AM, Alwaidh M, Appleton R, Baker GA, Chadwick DW, et al. The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial. Lancet. Mar 24 2007;369(9566):1016-26. [Medline].

  4. Peters DH, Sorkin EM. Zonisamide. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in epilepsy. Drugs. May 1993;45(5):760-87. [Medline].

  5. Kluger G, Bauer B. Role of rufinamide in the management of Lennox-Gastaut syndrome (childhood epileptic encephalopathy). Neuropsychiatr Dis Treat. Feb 2007;3(1):3-11. [Medline].

  6. [Best Evidence] Glauser T, Kluger G, Sachdeo R, Krauss G, Perdomo C, Arroyo S. Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome. Neurology. May 20 2008;70(21):1950-8. [Medline].

  7. Epilepsy and other seizure disorders. In: Ropper AH and Samuels M, eds. Adams and Victor's Principles of Neurology. 9th ed. New York: McGraw-Hill; 2009.

  8. Clark S, Wilson WA. Mechanisms of epileptogenesis. Adv Neurol. 1999;79:607-30. [Medline].

  9. Engel J, Pedley TA. Generalized convulsive seizures. In: Engel J, Pedley TA, eds. Epilepsy: A Comprehensive Textbook. 3 vol. Philadelphia: Lippincott-Raven; 1997:2417-2426.

  10. Kerrigan JF, Fisher RS. Recurrent generalized and partial epilepsy. In: Current Therapy in Neurologic Disease. Philadelphia: BC Decker; 1997:52-53.

Further Reading

Keywords

partial seizures, tonic-clonic activity, tonic-clonic seizures, generalized tonic-clonic seizure, GTCS, epilepsy, generalized seizures, seizure treatment, focal seizures, localization-related seizures, sudden death in epilepsy, SUDEP, generalized convulsive seizures, grand mal seizure

Contributor Information and Disclosures

Author

David Y Ko, MD, Associate Professor, Department of Neurology, University of Southern California Keck School of Medicine
David Y Ko, MD is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Medical Association, and California Medical Association
Disclosure: Pfizer Honoraria Speaking and teaching; UCB Grant/research funds clinical trials; Johnson and Johnson Grant/research funds clinical trials

Coauthor(s)

Soma Sahai-Srivastava, MD, Director of Neurology Ambulatory Care Services, LAC and USC Medical Center; Assistant Professor, Department of Neurology, University of Southern California
Soma Sahai-Srivastava, MD is a member of the following medical societies: American Academy of Neurology, American Headache Society, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Ramon Diaz-Arrastia, MD, PhD, Assistant Professor, Department of Neurology, Comprehensive Epilepsy Center, University of Texas Southwestern
Ramon Diaz-Arrastia, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, New York Academy of Sciences, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jose E Cavazos, MD, PhD, FAAN, Associate Professor with Tenure, Departments of Neurology, Pharmacology, and Physiology, University of Texas Health Science Center at San Antonio; Co-Director, South Texas Comprehensive Epilepsy Center; Director of the Epilepsy Center, Audie L Murphy Veterans Affairs Medical Center
Jose E Cavazos, MD, PhD, FAAN is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, and Society for Neuroscience
Disclosure: Glaxo-SmithKline Honoraria Consulting; Ortho-McNeil Neurologics Honoraria Consulting; UCB Pharma Honoraria Consulting

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

 
 
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