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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
Evaluation of the Neonate with Seizures.
Martin M, Querubin J, Hagen E, Lim J
Pediatr Ann 2020 Jul 1;49(7):e292-e298. doi: 10.3928/19382359-20200623-01. PMID: 32674166
Seizures after transplantation.
Lin P, Tian X, Wang X
Seizure 2018 Oct;61:177-185. Epub 2018 Aug 12 doi: 10.1016/j.seizure.2018.08.010. PMID: 30179843
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.
Zupanc ML
Pediatr Clin North Am 2004 Aug;51(4):961-78, ix. doi: 10.1016/j.pcl.2004.03.002. PMID: 15275983

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
Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009.
Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde Boas W, Engel J, French J, Glauser TA, Mathern GW, Moshé SL, Nordli D, Plouin P, Scheffer IE
Epilepsia 2010 Apr;51(4):676-85. Epub 2010 Feb 26 doi: 10.1111/j.1528-1167.2010.02522.x. PMID: 20196795

Therapy

Antiseizure medications for idiopathic generalized epilepsies: a systematic review and network meta-analysis.
Chu H, Zhang X, Shi J, Zhou Z, Yang X
J Neurol 2023 Oct;270(10):4713-4728. Epub 2023 Jun 28 doi: 10.1007/s00415-023-11834-8. PMID: 37378757Free 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
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
Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial.
Thiele EA, Marsh ED, French JA, Mazurkiewicz-Beldzinska M, Benbadis SR, Joshi C, Lyons PD, Taylor A, Roberts C, Sommerville K; GWPCARE4 Study Group
Lancet 2018 Mar 17;391(10125):1085-1096. Epub 2018 Jan 26 doi: 10.1016/S0140-6736(18)30136-3. PMID: 29395273
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

Prognosis

Incidence of Neonatal Seizures in China Based on Electroencephalogram Monitoring in Neonatal Neurocritical Care Units.
Yan K, Cheng G, Zhou W, Xiao F, Zhang C, Wang L, Zhang P, Lu C, Kong Y, Wang X, Zhou Y, Lu W, Tang J, Song X, Wei Q, Meng D, Yao L, Zhuang D, Qu L, Xu Q, Yin Z, Su L, Wan J, Si Y, Fujioka K, Mussap M, Kanungo S, Bhandari V, Huang W, Pan X, Zhou W; China Neonatal Neuro-Critical Care Network group
JAMA Netw Open 2023 Jul 3;6(7):e2326301. doi: 10.1001/jamanetworkopen.2023.26301. PMID: 37505497Free PMC Article
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
Mortality after a first-ever unprovoked seizure.
Pang EW, Lawn ND, Lee J, Dunne JW
Epilepsia 2023 May;64(5):1266-1277. Epub 2023 Mar 15 doi: 10.1111/epi.17567. PMID: 36861353
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
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
PIGN encephalopathy: Characterizing the epileptology.
Bayat A, de Valles-Ibáñez G, Pendziwiat M, Knaus A, Alt K, Biamino E, Bley A, Calvert S, Carney P, Caro-Llopis A, Ceulemans B, Cousin J, Davis S, des Portes V, Edery P, England E, Ferreira C, Freeman J, Gener B, Gorce M, Heron D, Hildebrand MS, Jezela-Stanek A, Jouk PS, Keren B, Kloth K, Kluger G, Kuhn M, Lemke JR, Li H, Martinez F, Maxton C, Mefford HC, Merla G, Mierzewska H, Muir A, Monfort S, Nicolai J, Norman J, O'Grady G, Oleksy B, Orellana C, Orec LE, Peinhardt C, Pronicka E, Rosello M, Santos-Simarro F, Schwaibold EMC, Stegmann APA, Stumpel CT, Szczepanik E, Terczyńska I, Thevenon J, Tzschach A, Van Bogaert P, Vittorini R, Walsh S, Weckhuysen S, Weissman B, Wolfe L, Reymond A, De Nittis P, Poduri A, Olson H, Striano P, Lesca G, Scheffer IE, Møller RS, Sadleir LG
Epilepsia 2022 Apr;63(4):974-991. Epub 2022 Feb 18 doi: 10.1111/epi.17173. PMID: 35179230
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

Recent systematic reviews

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
Sleep quality and architecture in Idiopathic generalized epilepsy: A systematic review and meta-analysis.
Lehner J, Frueh JS, Datta AN
Sleep Med Rev 2022 Oct;65:101689. Epub 2022 Aug 17 doi: 10.1016/j.smrv.2022.101689. PMID: 36037570
Deep brain stimulation targets in epilepsy: Systematic review and meta-analysis of anterior and centromedian thalamic nuclei and hippocampus.
Vetkas A, Fomenko A, Germann J, Sarica C, Iorio-Morin C, Samuel N, Yamamoto K, Milano V, Cheyuo C, Zemmar A, Elias G, Boutet A, Loh A, Santyr B, Gwun D, Tasserie J, Kalia SK, Lozano AM
Epilepsia 2022 Mar;63(3):513-524. Epub 2022 Jan 3 doi: 10.1111/epi.17157. PMID: 34981509
Febrile seizures.
Mewasingh LD
BMJ Clin Evid 2014 Jan 31;2014 PMID: 24484859Free PMC Article

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