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Myoclonic-astatic
seizures (atonic or drop attacks)
The myoclonic-astatic
seizure is rare and unique to MAE, and is one of the most
important and distinct features which helps distinguish it from
other epilepsy syndromes.
Like myoclonic seizures,
myoclonic-astatic seizures (also called atonic or drop
attacks) are sudden, single events. Myoclonic-astatic
seizures involve
abrupt loss of muscle control causing the person to fall to the
ground, often resulting in injury. For any family and child, the
sudden, violent impact and resultant injuries seen with
myoclonic-astatic seizures makes them one of the most
frightening and distressing types of seizures to live with.
As the label
myoclonic-astatic epilepsy (MAE) suggests, myoclonic-astatic
seizures are the core seizure type associated with the disorder. In MAE, myoclonic-astatic seizures can be serious because they
may be difficult to control, occur frequently on a daily basis
putting the child at persistent risk of injury, and because they
are only one manifestation of this mixed seizure disorder.
What happens?
Astatic seizures are sudden
involuntary events like myoclonic seizures, however, rather than
a sudden increase in muscle tone causing a jerk, astatic
seizures involve sudden loss of muscle tone.
Myoclonic-astatic seizures we see in MAE involve this astatic
seizure (loss of muscle tone) often preceded by a short
myoclonia (jerk) component as well. Arms, legs, or torso
muscles that support the body by their tone, suddenly go limp;
the body gives way with a jolt. The torso may slump, the legs
may give way, or the body may fall to the ground. If a
myoclonic-astatic seizure occurs while a child is standing, the
seizure may cause the child to slam violently to the ground,
perhaps hitting his/her face, breaking a tooth, or causing a
facial laceration.
Like myoclonic seizures,
astatic seizures arise from deep structures in the brain stem
that control muscle tone. Since the areas that increase tone are
close to those that decrease tone, children with seizures
involving sudden changes in tone may have either myoclonic or
astatic seizures and often both which is what we see typically
with MAE.
As is the case with all
generalised seizures, the child is not conscious during the
event but the seizure is so brief that he/she usually recovers
quickly. Sometimes a child may be mildly agitated or
disorientated following an astatic seizure. If injury has
resulted, he/she may be duly distressed.
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See
also
Seizures - Myoclonic seizures
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See
also
Safety - Protecting your child from injury
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See
also
Safety - Protective helmets
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See
also
Safety -
Educating
your caregiver
What to do
Don't
- Restrain the child
- Act in a way that
could frighten the child, eg abrupt movements or shouting at
them
- Assume the person
is aware of what is happening or what has happened
- Give the child
anything to eat or drink until they are fully recovered
- Attempt to bring
them round
Call an
ambulance if....
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