Causative & risk factors
Grand mal seizure is an epileptic disorder. Some other underlying problems can also give rise to these seizures. These include brain infections, hypoxia, head injury, electrolyte abnormalities, hyoglycemia and malformations of blood vessels. Alcohol or substance abuse can also give rise to seizures.
Clinical presentation
Grand mal seizures occur in 2 phases: tonic and clonic. In the tonic phase, the person loses consciousness and falls down. This phase lasts for not more than 20 seconds. In the clonic phase, the muscles undergo alternate contractions and relaxation in a rhythmic manner. This phase lasts for not more than 2 minutes. Loss of bowel and bladder control is a common finding. After a seizure, the person may feel fatigued or confused.
Before the onset of a seizure, some persons may experience a few warning symptoms; this is known as aura. Each person who experiences aura experiences his individual set of symptoms during this period.
Investigations
Details of the seizure will be collected from the onlookers along with a detailed medical history of the patient. A thorough examination is performed, followed by an EEG (electroencephalogram). CT or MRI of the brain is usually suggested.
Treatment
A person who has only had a single seizure is not put onto any medication. Treatment is reserved for those who have had more than 1 seizure. Such patients are given anti-epilepsy drugs. A high saturated fat diet is recommended.
Epileptic activity excitable areas of the brain are identified and neuroablation procedure is carried out; this is helpful in some patients with recurrent Grand mal seizures.

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