By LOUISE CARR, Associate Editor and Featured Columnist
Imagine a state where your muscles stiffen and jerk and your limbs thrash uncontrollably – but you don’t even know it’s happening until you come round, disoriented and tired. This is known as a "tonic clonic seizure" – previously called a "grand mal seizure" – and it is one of the different types of seizure to occur in epilepsy.
Epilepsy and these kinds of seizures are not as rare as you may think.
The Citizens United for Research in Epilepsy says that 1 in 26 Americans will suffer from epilepsy in their lifetime, and around 3 million people currently live with epilepsy in America.
Epilepsy may be relatively common but witnessing, or experiencing, this kind of epileptic seizure is certainly traumatic. And the tonic clonic seizure can also be dangerous, even fatal.
The Citizens United for Research in Epilepsy estimates that up to 50,000 deaths occur every year in the US related to epilepsy seizures like tonic clonic seizures.
A tonic clonic seizure can be especially dangerous as it can affect a person’s safety at a critical moment, for example contributing to drowning, an auto accident, or a fatal fall - Sudden Unexpected Death in Epilepsy (SUDEP) accounts for 34 percent of all sudden deaths in children.
Why Is It Called a Tonic Clonic Seizure?
Tonic in medicine is a word relating to tension, as in the muscles. Clonic, in medical terms, is marked by contraction and relaxation of muscle. In the tonic phase of a seizure, the muscles stiffen and the person loses consciousness and falls to the floor.
In the clonic phase, the limbs jerk rapidly without control.
Tonic clonic seizures last around one to three minutes and recovery time is relatively long compared to other types of seizures in epilepsy.
When a person regains consciousness they feel drowsy, agitated, confused or depressed.
What Are the Causes of Tonic Clonic Seizures?
A tonic clonic seizure occurs with epilepsy. Epilepsy is a brain condition which results in seizures. During a seizure like a tonic clonic seizure, the neurons in the brain are abnormally active, firing electrical impulses which cause strange and involuntary body movements.
Epilepsy may start at any age but it most commonly begins in childhood. In two thirds of people with epilepsy, the cause is unknown says Citizens United for Research in Epilepsy. In epilepsy sufferers, anyone can experience tonic clonic seizures and they affect adults and children.
Tonic clonic seizures and other seizures in epilepsy are treated in a variety of ways. There are anti-seizure medications, but these come with side effects. The technique of vagus nerve stimulation can help people who suffer from these seizures. Other remedies have also been researched for the treatment of tonic clonic seizures, although nothing is thought to completely cure the condition.
We looked at recent scientific research to find out more.
1. A Ketogenic Diet Actually Helps Reduce Tonic Clonic Seizures
Before there were any effective medications for epilepsy, doctors noticed something strange --- people who fasted tended to have fewer seizures.
Further investigation revealed that the state of "ketosis" during fasting was responsible.
Ketosis develops during fasting and also when you eat a diet high in fat and low in carbohydrates. This diet is called a ketogenic diet.
The ketogenic diet is often used as a treatment for people whose epilepsy does not respond to drug treatment.
Studies like a 1996 study from Tufts University School of Medicine, Boston say that the ketogenic diet stops seizures in around half of all children on the diet, and it reduces the frequency of tonic clonic and other seizures in around another third of people.
But there are significant side effects associated with the ketogenic diet, including nausea, fatigue, dehydration, mental confusion, constipation, and reduced immunity. Also, the diet can cause kidney stones and impair liver function.
2. The Atkins Diet is Better Tolerated for Controlling Tonic Clonic Seizures
While the ketogenic diet is effective for controlling tonic clonic seizures, it is not well-tolerated.
But the Atkins Diet is better tolerated and it also works to control seizures. The Atkins Diet can also contribute towards a ketonic state and it is easier to stick to, with fewer protein restrictions, according to a paper entitled “Eating Your Way to Seizure Control” by Carl E. Stafstrom, M.D., Ph.D. in 2004.
In the study the author looked at six patients aged between seven years and 52 years, who were started on the Atkins Diet. Five people experienced the state of ketosis which contributed to fewer seizures, while three patients experienced a reduction in their seizures and were able to reduce their seizure medication.
3. Tonic Clonic Seizures are Linked to the Menstrual Cycle
A 2011 study from Beth Israel Deaconess Medical Center in Boston, Massachusetts shows that women who suffer from tonic clonic seizures have a greater number of these seizures during a menstrual cycle where an egg is not released, as compared to a menstrual cycle where ovulation happens.
Researchers looked at data from the Progesterone Trial Study, which was a three-month study into progesterone therapy for seizures.
In the study, 281 women participated, of which 37 percent suffered from tonic clonic seizures. Researchers found that the average daily seizure frequency was 30 percent greater in the women during their non-ovulation cycles than in ovulation cycles.
4. Can Traditional Chinese Herbal Remedies Help Control Tonic Clonic Seizures?
A traditional Chinese remedy known by the Japanese names "saiko-keishi-to" and "sho-saiko-to" may help reduce the tonic clonic and other seizures associated with epilepsy.
According to a 1993 study from Katsushikabashi Hospital, Tokyo, Japan, combination treatments with bupleurum, ginger root, peony root, cassia bark, jujube fruit, pinellia root, licorice root, and Asian ginseng root can help – but the evidence is not conclusive.
5. Nigella Seed May Reduce Tonic Clonic Seizures in Children
A 2007 study from Ghaem Medical Center, Mashhad, Iran looked at 20 children aged from 13 months to 13 years who were given treatment with water extract of Nigella sativa L. over a period of four weeks.
The extract of the Nigella (black cumin) seed helped control seizures in children, according to the researchers.
6. Stress Can Trigger Tonic Clonic Seizures
Researchers say that stress increases the frequency and severity of seizures like tonic clonic seizures because in epilepsy the brain changes the way it reacts to stress, which can result in seizures.
A 2016 study from the University of Western Ontario in Canada looked at the activity of corticotropin-releasing factor (CRF), a neurotransmitter, in rat brains with and without epilepsy.
This neurotransmitter regulates the body’s response to stress.
Experts suggest that people who suffer from tonic clonic seizures try to avoid stressful situations as much as possible, and investigate ways to deal with stress before it becomes a problem.
7. Control Tonic Clonic Seizures with Fish Oil
A 2014 study from the University of California-Los Angeles (UCLA) School of Medicine demonstrates that the frequency of tonic clonic seizures is reduced by consuming omega 3 fish oil every day.
The study showed that consuming 1,080 mg of fish oil a day for 10 weeks resulted in a reduction of seizures by one third.
Omega 3 fatty acids are found in oily fish like trout, tuna, mackerel, herring, and salmon, as well as in supplements. The study looked at 24 people whose epilepsy was not controlled with medication.