ACUTE CONVULSIONS

Acute convulsions are epileptic seizures occurring in (or leading to) an acute or severe clinical condition. In a four-year-period, a total of 146 patients with documented acute convulsions were found. The vast majority (108) were above 21 years and a large number (65) over 50 years. In 48 patients, the seizures were frequent and/or prolonged enough to be listed as status epilepticus. Tonic-clonic seizures (grand mal) were mostcommon (92 patients), followed by focal motor (partial) seizures (44) and myoclonus (20 - in 9 of them combined with grand mal). The most common etiology was cerebrovascular disorder (mostly in association with acute stroke). A history of epileptic seizures prior to the outbreak of acute convulsions was found in 37 patients. Special emphasis was placed on epileptic manifestations in acute cerebral anoxia (20 cases). In these patients, myoclonus is seen in conjunction with profound “rostro-caudal degeneration” leading to a “midbrain syndrome”; suppression-burst activity in the EEG is usually associated with this picture. With further deterioration, the convulsive activity ceases (“bulbar syndrome”). Therapeutic outlines are given. The prognosis of acute convulsions is guarded or outright poor, especially in cases of anoxia, metabolic disorder and brain tumor; fifty-five patients died. © 1979, American Medical Electroencephalographic Association. All rights reserved.