The term convulsion refers to intense paroxysm of involuntary repetitive muscular contraction resulting from excessive and disorderly discharge of cerebral nervous tissues on muscles. This term is considered inappropriate for a disorder that may consist only an alteration of sensation or consciousness. Seizure is a preferable term, since it embraces a diversity of paroxysmal events and lends itself to qualification. Seizure defined as uncontrollable excessive and hyper synchronous discharge of cortical neurons, the clinical consequence of which may range from a convulsion to none at all. The term “motor or convulsive seizure” is therefore not tautology and one may likewise speak of “sensory seizure or psychic seizure”. The word Epilepsy is derived from the Greek word “to seize upon” or a “taking hold of”. Although a useful medical term to denote the recurrent seizure, the word epilepsy and “epileptic” still have unpleasant connotation to the several public and should be used advisedly in dealing with patients.
Convulsion is a common symptom, but determining the prevalence of Epilepsy has proven very difficult, which is however put at about 3-5/100,000 persons in Nigeria.
There are many things that can make someone convulse, ranging from fever in children less than 6 years to head injuries, metabolic derangements (e.g. hypoglycaemia, hyponatremia etc), poisoning, drug overdose, etc in any age group.
The convulsion that you will see in the Community can be classified in the simplest way into generalized convulsions, involving the whole body particularly the hands, legs and face and the person is usually unconscious at the time of attack. While in partial convulsions, the problem is usually localized to one part of the body. The person may be fully aware of what is happening (simple partial convulsion) or may not be conscious (complex partial convulsion). Sometimes what started as a partial convulsion may sequentially involve the whole body (secondarily generalized convulsion) and a simple convulsion may become complex in which case the person who has experienced this before may view the simple convulsion as a sign of the impending complex convulsions which they view as the actual convulsion in such case, the preceding simple form is referred to as ‘Aura’
The manifestation of convulsions range from thumb twitching, repeated blinking and lid smacking in children to jerky muscle contractions in older children and adults. Symptoms and signs of convulsion include:
A strange cry preceding the attack (sometimes)
A sudden fall to the ground with the person rigid and unconscious.
Uncontrolled jerking movement of the body and limb muscles
Already breathing or noisy breathing
Frothy (foaming) at the mouth (sometimes)
Loss of bladder control
Blood on the lips if the tongue is bitten
No memory of the fit on awakening
Temporary confusion after the fit is over and the need to sleep.
FIRST AID TREATMENT
The following tips will help you arrest a person who is convulsing in the absence of a doctor:
Stay calm and protect the person by removing dangerous objects from around the person.
Keep people away from overcrowding the person to allow fresh air
Do not attempt to restrain the person
Place something soft under the person head to protect it and loosen any tight clothing
Give reassurance as the consciousness return and help the person more to a place where it will be possible to sleep
Seek urgent medical help especially if it is the first time the person is convulsing.
WHAT TO DO:
Do not try to put anything into the person’s mouth as that may cause further injury to the person
Do not retrain the convulsing limbs, it can lead to fracture
Do not attempt to give the person medications or fluids by mouth why they are not interactive, they can aspirate and die.
If the above tips are followed by anybody, you are likely to do more good than harm to the person who is convulsing.
References:
- Epilepsy and other seizure disorder, Adams and Victor’s principles of Neurology, 8th Edition
- Epilepsy: Jeremy D. Slater M.D
- Convulsions, www.Familydoctors.com
- Seizures and Epilepsy: Frequently asked questions.
- Dr Courage Uhunmwangho
- Registrar Department of Internal Medicine
- Jos University Teaching Hospital, JUTH
