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Precipitating factors including infections, fever, and emotional stress.

Tonic phase : sudden loss of consciousness , tonic contractions , apnea ,

cyanosis and eye rolling

Clonic phase : rhythmic clonic contractions with tongue biting and incontinence

Post ictal :( 30 min – 2 hours) the child feels headache, confusion, and ataxia or

remains in deep sleep.

Atonic seizure

Sudden loss of cosciousness and loss of body tone → falling down

Myoclonic epilepsies

Sudden shock like movements of extremities and trunk without loss of

consciousness ( symmetrical contraction of groups of muscles )

Infantile spasms (west syndrome)

Onset : 4-8 month

Spasms: occurs in clusters of 3 types.

Flexor : sudden flexion of neck ,arms and legs

Extensor : extension of arms and extremities

Mixed : extensor in some and flexion in others

EEG : hypsarrhythmia ( chaotic high voltage slow waves )

Causes :

Cryptogenic 20 %: good prognosis

Secondary 80 %: associated with mental retardation due to brain hypoxia,

congenital infections, inborne error of metabolism

Treatment : specific treatment

ACTH: to suppress CRH (corticotrophin releasing hormone) → decrease

neuronal excitability.

Clonazepan.