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Generalized atonic seizure

MedGen UID:
1719490
•Concept ID:
C5397892
•
Disease or Syndrome
Synonyms: Generalised atonic seizure; Generalized onset atonic epileptic seizure; Generalized-onset atonic epileptic seizure
SNOMED CT: Generalized atonic seizure (1208968000); Generalized onset atonic epileptic seizure (1208968000); Generalized-onset atonic epileptic seizure (1208968000)
 
HPO: HP:0032887

Definition

Generalized atonic seizure is a type of generalized motor seizure characterized by a sudden loss or diminution of muscle tone without apparent preceding myoclonic or tonic event lasting about 1-2 s, involving head, trunk, jaw, or limb musculature. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVGeneralized atonic seizure

Professional guidelines

PubMed

ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: Position statement by the ILAE Task Force on Nosology and Definitions.
Zuberi SM, Wirrell E, Yozawitz E, Wilmshurst JM, Specchio N, Riney K, Pressler R, Auvin S, Samia P, Hirsch E, Galicchio S, Triki C, Snead OC, Wiebe S, Cross JH, Tinuper P, Scheffer IE, Perucca E, Moshé SL, Nabbout R
Epilepsia 2022 Jun;63(6):1349-1397. Epub 2022 May 3 doi: 10.1111/epi.17239. PMID: 35503712
Management of status epilepticus: a narrative review.
Migdady I, Rosenthal ES, Cock HR
Anaesthesia 2022 Jan;77 Suppl 1:78-91. doi: 10.1111/anae.15606. PMID: 35001380
Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management.
Abboud H, Probasco JC, Irani S, Ances B, Benavides DR, Bradshaw M, Christo PP, Dale RC, Fernandez-Fournier M, Flanagan EP, Gadoth A, George P, Grebenciucova E, Jammoul A, Lee ST, Li Y, Matiello M, Morse AM, Rae-Grant A, Rojas G, Rossman I, Schmitt S, Venkatesan A, Vernino S, Pittock SJ, Titulaer MJ; Autoimmune Encephalitis Alliance Clinicians Network
J Neurol Neurosurg Psychiatry 2021 Jul;92(7):757-768. Epub 2021 Mar 1 doi: 10.1136/jnnp-2020-325300. PMID: 33649022Free PMC Article

Recent clinical studies

Etiology

Update on first unprovoked seizure in children and adults: A narrative review.
Jiménez-Villegas MJ, Lozano-García L, Carrizosa-Moog J
Seizure 2021 Aug;90:28-33. Epub 2021 Mar 30 doi: 10.1016/j.seizure.2021.03.027. PMID: 33840584
Medical management for neurosurgical related seizures.
Ambrosi M, Orsini A, Verrotti A, Striano P
Expert Opin Pharmacother 2017 Oct;18(14):1491-1498. Epub 2017 Sep 1 doi: 10.1080/14656566.2017.1373092. PMID: 28847180
Seizure-related autonomic changes in children.
Moseley BD
J Clin Neurophysiol 2015 Feb;32(1):5-9. doi: 10.1097/WNP.0000000000000138. PMID: 25647767
ILAE official report: a practical clinical definition of epilepsy.
Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J Jr, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S
Epilepsia 2014 Apr;55(4):475-82. Epub 2014 Apr 14 doi: 10.1111/epi.12550. PMID: 24730690
Neonatal seizures.
Silverstein FS, Jensen FE
Ann Neurol 2007 Aug;62(2):112-20. doi: 10.1002/ana.21167. PMID: 17683087

Diagnosis

A practical review of functional neurological disorder (FND) for the general physician.
Bennett K, Diamond C, Hoeritzauer I, Gardiner P, McWhirter L, Carson A, Stone J
Clin Med (Lond) 2021 Jan;21(1):28-36. doi: 10.7861/clinmed.2020-0987. PMID: 33479065Free PMC Article
Epilepsy Overview and Revised Classification of Seizures and Epilepsies.
Pack AM
Continuum (Minneap Minn) 2019 Apr;25(2):306-321. doi: 10.1212/CON.0000000000000707. PMID: 30921011
Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology.
Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, Jansen FE, Lagae L, Moshé SL, Peltola J, Roulet Perez E, Scheffer IE, Zuberi SM
Epilepsia 2017 Apr;58(4):522-530. Epub 2017 Mar 8 doi: 10.1111/epi.13670. PMID: 28276060
ILAE official report: a practical clinical definition of epilepsy.
Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J Jr, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S
Epilepsia 2014 Apr;55(4):475-82. Epub 2014 Apr 14 doi: 10.1111/epi.12550. PMID: 24730690
Neonatal seizures.
Silverstein FS, Jensen FE
Ann Neurol 2007 Aug;62(2):112-20. doi: 10.1002/ana.21167. PMID: 17683087

Therapy

Disulfiram-induced epileptic seizures.
Nogueira V, Mendes MA, Pereira I, Teixeira J
BMJ Case Rep 2021 Mar 17;14(3) doi: 10.1136/bcr-2020-236296. PMID: 33731397Free PMC Article
Update on the management of status epilepticus.
Rossetti AO, Alvarez V
Curr Opin Neurol 2021 Apr 1;34(2):172-181. doi: 10.1097/WCO.0000000000000899. PMID: 33664203
Nonepileptic seizures: an updated review.
Perez DL, LaFrance WC Jr
CNS Spectr 2016 Jun;21(3):239-46. Epub 2016 Mar 21 doi: 10.1017/S109285291600002X. PMID: 26996600Free PMC Article
Neonatal seizures.
Silverstein FS, Jensen FE
Ann Neurol 2007 Aug;62(2):112-20. doi: 10.1002/ana.21167. PMID: 17683087
Nonconvulsive seizures.
Jagoda A
Emerg Med Clin North Am 1994 Nov;12(4):963-71. PMID: 7956893

Prognosis

Development of Expert-Level Classification of Seizures and Rhythmic and Periodic Patterns During EEG Interpretation.
Jing J, Ge W, Hong S, Fernandes MB, Lin Z, Yang C, An S, Struck AF, Herlopian A, Karakis I, Halford JJ, Ng MC, Johnson EL, Appavu BL, Sarkis RA, Osman G, Kaplan PW, Dhakar MB, Arcot Jayagopal L, Sheikh Z, Taraschenko O, Schmitt S, Haider HA, Kim JA, Swisher CB, Gaspard N, Cervenka MC, Rodriguez Ruiz AA, Lee JW, Tabaeizadeh M, Gilmore EJ, Nordstrom K, Yoo JY, Holmes MG, Herman ST, Williams JA, Pathmanathan J, Nascimento FA, Fan Z, Nasiri S, Shafi MM, Cash SS, Hoch DB, Cole AJ, Rosenthal ES, Zafar SF, Sun J, Westover MB
Neurology 2023 Apr 25;100(17):e1750-e1762. Epub 2023 Mar 6 doi: 10.1212/WNL.0000000000207127. PMID: 36878708Free PMC Article
Update on first unprovoked seizure in children and adults: A narrative review.
Jiménez-Villegas MJ, Lozano-García L, Carrizosa-Moog J
Seizure 2021 Aug;90:28-33. Epub 2021 Mar 30 doi: 10.1016/j.seizure.2021.03.027. PMID: 33840584
Status epilepticus.
Hirsch LJ, Gaspard N
Continuum (Minneap Minn) 2013 Jun;19(3 Epilepsy):767-94. doi: 10.1212/01.CON.0000431395.16229.5a. PMID: 23739110Free PMC Article
Neonatal seizures.
Stafstrom CE
Pediatr Rev 1995 Jul;16(7):248-55; quiz 256. doi: 10.1542/pir.16-7-248. PMID: 7624277
Myoclonic-astatic epilepsy.
Doose H
Epilepsy Res Suppl 1992;6:163-8. PMID: 1418479

Clinical prediction guides

Motor seizure semiology.
Wu S, Nordli DR
Handb Clin Neurol 2023;196:295-304. doi: 10.1016/B978-0-323-98817-9.00014-4. PMID: 37620075
Update on first unprovoked seizure in children and adults: A narrative review.
Jiménez-Villegas MJ, Lozano-García L, Carrizosa-Moog J
Seizure 2021 Aug;90:28-33. Epub 2021 Mar 30 doi: 10.1016/j.seizure.2021.03.027. PMID: 33840584
Learnings from 30 years of reported efficacy and safety of vagus nerve stimulation (VNS) for epilepsy treatment: A critical review.
Toffa DH, Touma L, El Meskine T, Bouthillier A, Nguyen DK
Seizure 2020 Dec;83:104-123. Epub 2020 Oct 10 doi: 10.1016/j.seizure.2020.09.027. PMID: 33120323
Current understanding of febrile seizures and their long-term outcomes.
Mewasingh LD, Chin RFM, Scott RC
Dev Med Child Neurol 2020 Nov;62(11):1245-1249. Epub 2020 Aug 3 doi: 10.1111/dmcn.14642. PMID: 32748466
Chance and risk in epilepsy.
Baud MO, Proix T, Rao VR, Schindler K
Curr Opin Neurol 2020 Apr;33(2):163-172. doi: 10.1097/WCO.0000000000000798. PMID: 32049738

Recent systematic reviews

Guidelines for Seizure Prophylaxis in Adults Hospitalized with Moderate-Severe Traumatic Brain Injury: A Clinical Practice Guideline for Health Care Professionals from the Neurocritical Care Society.
Frontera JA, Gilmore EJ, Johnson EL, Olson D, Rayi A, Tesoro E, Ullman J, Yuan Y, Zafar SF, Rowe S
Neurocrit Care 2024 Jun;40(3):819-844. Epub 2024 Feb 5 doi: 10.1007/s12028-023-01907-x. PMID: 38316735
Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies.
Solmi M, De Toffol M, Kim JY, Choi MJ, Stubbs B, Thompson T, Firth J, Miola A, Croatto G, Baggio F, Michelon S, Ballan L, Gerdle B, Monaco F, Simonato P, Scocco P, Ricca V, Castellini G, Fornaro M, Murru A, Vieta E, Fusar-Poli P, Barbui C, Ioannidis JPA, Carvalho AF, Radua J, Correll CU, Cortese S, Murray RM, Castle D, Shin JI, Dragioti E
BMJ 2023 Aug 30;382:e072348. doi: 10.1136/bmj-2022-072348. PMID: 37648266Free PMC Article
Electronic cigarettes and health outcomes: umbrella and systematic review of the global evidence.
Banks E, Yazidjoglou A, Brown S, Nguyen M, Martin M, Beckwith K, Daluwatta A, Campbell S, Joshy G
Med J Aust 2023 Apr 3;218(6):267-275. Epub 2023 Mar 20 doi: 10.5694/mja2.51890. PMID: 36939271Free PMC Article
Neurostimulation in generalized epilepsy: A systematic review and meta-analysis.
Haneef Z, Skrehot HC
Epilepsia 2023 Apr;64(4):811-820. Epub 2023 Feb 16 doi: 10.1111/epi.17524. PMID: 36727550
Epileptic Seizures Under Antidepressive Drug Treatment: Systematic Review.
Steinert T, Fröscher W
Pharmacopsychiatry 2018 Jul;51(4):121-135. Epub 2017 Aug 29 doi: 10.1055/s-0043-117962. PMID: 28850959

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