Grand Mal Seizure In Older Adults – It Sometimes May Occur In the Absence of Any Known Risks
You may have noticed sudden stiffness in body, loss of consciousness, slow jerking movements in you or your dear one. These sudden changes are symptoms of seizure, the tonic-clonic or grand mal seizures. They are actually caused by electric disturbances in the brain. The presentations of seizure differ with different age group. According to the report of epilepsy foundation, the older adults (people aged 65 and above) are the fastest growing population to be affected by grand mal seizure. It is believed that there are two peak durations, in which the inception of epilepsy is more likely; the first is in the childhood and the other is after the age of 65.
AEDs Are Commonly Prescribed For Seizures
Notice Their Behavior They Might Not Discuss Their Problem With You
When parents notice that their child having generalized seizure, they discuss it with friends and family and make it more public. But when this develops to older adults, it is less likely that they become open about it. The disease carries a stigma with it and mostly stays as hidden disease in them.
It is still not identified the full breadth of possible symptoms and classifications of epilepsy in older adults. There is only a preconceived notion that older patients have focal seizures and results in different manifestations that includes;
- Staring
- Lip smacking
- Brief unresponsiveness
- Language difficulties
- Confusion
Diagnosing Epilepsy In Older Adults Isn’t Straightforward
The Possible Causes Of Grand Mal Seizure In Older Adult
Seizures among the older adults might occur by myriad factors that affect the brain. According to epilepsy foundation, seizures in the older adults can be linked with physical changes in the brain caused by heart disease, alzheimer’s disease, brain tumors or stroke. However, in half of the cases of epilepsy in older patients, the origin has been unidentified. Seizure may occur in the absence of any known risk and the factors that may increase the risk of developing grand mal seizure can also not be categorized. In the epilepsy world it is believed that epilepsy develops at the age of 65 because of the structural brain abnormality and most of the time it is focal when it takes place first time.
AEDs As Medication For Older Seizure Patients
Appropriate medications and dosages for older patients should be consulted well with a physician. First-generation AEDs (carbamazepine, pheytoin) produces numbing effect and so are commonly prescribed for grand mal seizure. Although these drugs works best on younger patients, they may cause memory problem and gait instability for older ones. Second-generation AEDs such as lamotrigine and gabapentin are better tolerated and are more proffered previous one. However these new drugs are more expensive. Other then drugs there are more activities that can be discussed with the physicion to avoid possible danger for older patients.
Do Not Restrict Their Life Around The Disease
The older adults diagnosed with seizures have to adjust with various things considering their activities. They should not be restricted to live their life around the disease. The caregivers should focus on a balance between giving them an independent and active life while suggesting them few personal and public safety measures. Most of the time seizure’s symptoms in older adults are misinterpreted and results in more critical condition. Family can assist well a practitioner at the time of diagnosis as without a through patient history it’s not easy for them to come out on a conclusion or for further tests.
What Fractures can Result from Grand Mal Seizure?
Bilateral intracapsular fracture of hip is one of the rare consequences of grand mal seizure (GMS). Such cases have been reported mostly in elderly and adults. This fracture occurs in the proximal end of the femur. Femur is the long bone running through the thigh near the hip. Another complication can also result from the seizure which is called the femoral neck fracture. In this the narrow neck between the round head of the femur and the shaft gets ruptured. This can interfere with the blood flow to the upper end of the femur. Let us see how grand mal seizure causes fractures.
Fractures can result from grand mal seizure
How does GMS Cause Joint Fractures?
Grand mal seizure occurs when there is an abnormal electrical activity in the brain. This leads to severe muscular contraction. The person almost loses consciousness followed by trembling of the body. The musculoskeletal convulsions cause joint dislocations and fractures. Although such cases have been reported very rarely, the risk of contracting it remains in an incident of prolonged seizure. Physicians often miss them or diagnose them quite late. Delay will increase the chances of morbidity. Thorough musculoskeletal examination should be carried out in patients who have suffered a prolonged seizure and are under ventilation.
Remedies for the Joint Ruptures in Cases of GMS
The patients of GMS are usually administered with anti-epileptic drugs to ameliorate the symptoms. In case the drug fails, surgical processes are applied viz. vagal nerve stimulation. But in patients who have also suffered joint problems out the seizure, they have to be given additional treatments. The most common one is orthopedic surgery of the hips. However this is quite painful and keeps the patient immobilized for long. Patients are made to get mobilized as soon as possible with the help of physiotherapy or occupational therapy. In case of non-severe femoral fractures screws or sliding screw plates are used. In intracapsular fractures, the broken part is replaced with a metal implant. This also called hemiarthroplasty. Hip replacement also remains an option. But this is suitable for older people compared younger ones. The younger and active ones run the risk of wearing it out.
Femoral neck fracture can result from GMS, although rare
Final Words on Joint Fractures due to Grand Mal Seizure
I hope this article on joint fractures due to grand mal seizure was useful and wish all people be restored to good health with proper medical treatment, following seizure.
Grand Mal Seizure in Pregnancy
There are a lot of women that belong to the age bracket of childbearing years have seizure disorders. Once a woman with a history of grand mal seizure gets pregnant, she should immediately inform her physician about it. The common concerns during these kinds of pregnancies are increased seizure frequency, miscarriage, fetal malformation and prenatal death.
Effects of Drugs on Seizures and Baby
Grand Mal Seizure and Pregnancy
A pregnant woman who has a history of grand mal seizure is advised to decrease the intake of antiepileptic drugs. This is for the reason that there is an increased distribution volume and hepatic metabolism of the drug during pregnancy; and this can lead to fetal malformation. However, when a pregnant woman decreases her intake of antiepileptic drugs, there will be an increased seizure frequency.
Genetic Counseling for Seizures and Pregnancy
A lot of tests must be done to a woman who has a possibility of developing grand mal seizures during pregnancy, especially if she is regularly taking her medications for the illness. Genetic counseling must be done to the pregnant woman. There are some physicians who attempt to decrease the pharmacotherapy to monotherapy, and taper the dosages of the antiepileptic drugs to the lowest dose that is possible. There must also be a regular checkup of the total and free levels of antiepileptic drugs in the body of the pregnant woman. However, for pregnant women who have not had an incident of grand mal seizure for 2-5 years, there should be an attempt on complete withdrawal from the antiepileptic drugs. All of these interventions and management should be done under the supervision of a medical professional.