====== Grand mal seizure ======

Both terms, "grand mal seizure" and "tonic-clonic seizure," have been historically used to describe a specific type of epileptic seizure characterized by two distinct phases: the tonic phase and the clonic phase.

However, in recent years, there has been a shift towards using more precise and descriptive terminology in the field of epilepsy. The term "tonic-clonic seizure" is now considered more accurate and is commonly used by healthcare professionals. This term reflects the two main components of the seizure:

Tonic Phase: In this phase, there is a sudden and sustained muscle contraction, leading to stiffness.

Clonic Phase: This phase involves rhythmic, jerking muscle movements.

Using "[[tonic-clonic seizure]]" is preferred because it provides a clearer and more specific description of the seizure type. The term "grand mal seizure" is considered outdated and may not convey the detailed information needed for accurate medical communication.

===== Etiology =====

1. Primary (Idiopathic) Seizures:
No identifiable structural or metabolic cause.
Likely genetic predisposition or abnormalities in brain excitability.
Often part of generalized epilepsy syndromes.
2. Secondary (Symptomatic) Causes:
Secondary causes involve identifiable triggers or underlying conditions that provoke seizures.

Structural Brain Abnormalities:
Traumatic brain injury (TBI): Scarring or damage to brain tissue can disrupt electrical activity.
Stroke: Ischemia or hemorrhage in the brain can lead to seizures.
Brain tumors: Space-occupying lesions may irritate surrounding brain tissue.
Cerebral infections:
Encephalitis
Meningitis
Brain abscess
Congenital malformations: Disorders such as cortical dysplasia or microcephaly.
Metabolic and Systemic Factors:
Electrolyte imbalances:
Hypoglycemia or hyperglycemia
Hyponatremia or hypernatremia
Hypocalcemia
Hypoxia: Oxygen deprivation to the brain.
Toxicity:
Alcohol withdrawal or intoxication
Drug abuse (e.g., cocaine, amphetamines)
Medication side effects or withdrawal (e.g., antiepileptics, benzodiazepines)
Uremia or hepatic encephalopathy: Resulting from kidney or liver failure.
Infectious and Inflammatory Causes:
Neurocysticercosis (common in endemic areas)
HIV-associated neurocognitive disorders
Autoimmune encephalitis, such as anti-NMDA receptor encephalitis
Genetic Conditions:
Genetic epilepsies, such as Dravet syndrome or juvenile myoclonic epilepsy.
Chromosomal disorders, like Angelman syndrome.
3. Provoked or Reflex Seizures:
Fever: Febrile seizures in children (though not true grand mal seizures, these may evolve in certain epilepsy syndromes).
Sensory triggers: Flashing lights or loud sounds in photosensitive epilepsy.
Sleep deprivation or stress.
Acute injury or insult: Post-surgical, hypoxic, or post-infectious.
4. Unknown Causes:
In some cases, no definitive cause is identified even after thorough evaluation.