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Bilateral tonic-clonic seizure on awakening

MedGen UID:
335621
•Concept ID:
C1847165
•
Disease or Syndrome; Finding
Synonym: Morning generalized tonic-clonic seizures
 
HPO: HP:0007193

Definition

Bilateral tonic-clonic seizure of either generalized or focal onset occurring on or soon after wakening (typically within 90 minutes of waking, regardless of the time of day). [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVBilateral tonic-clonic seizure on awakening

Conditions with this feature

Epilepsy, idiopathic generalized, susceptibility to, 9
MedGen UID:
413424
•Concept ID:
C2750887
•
Finding
For a general phenotypic description and a discussion of genetic heterogeneity of idiopathic generalized epilepsy, see 600669. Juvenile myoclonic epilepsy is a subtype of idiopathic generalized epilepsy; see 254770 for a general phenotypic description and a discussion of genetic heterogeneity of JME.
See: Condition Record
Epilepsy, juvenile absence, susceptibility to, 1
MedGen UID:
413426
•Concept ID:
C2750892
•
Finding
Juvenile absence epilepsy is a subtype of idiopathic generalized epilepsy (IGE; see 600669). Manifestations occur around puberty, in contrast to childhood absence epilepsy (CAE; 600131), which begins at age 6 to 7 years. Absence seizures, generalized tonic-clonic seizures (GTCS), GTCS on awakening, and myoclonic seizures are the main features of JAE. (Commission on Classification and Terminology of the International League Against Epilepsy, 1989). Genetic Heterogeneity of Juvenile Absence Epilepsy See also susceptibility to juvenile absence epilepsy-2 (EJA2; see 607628), conferred by variation in the CLCN2 gene (600570) on chromosome 3q26.
See: Condition Record
Epilepsy, idiopathic generalized, susceptibility to, 11
MedGen UID:
416407
•Concept ID:
C2750893
•
Finding
Both juvenile myoclonic epilepsy and juvenile absence epilepsy are subtypes of idiopathic generalized epilepsy (EIG). For a general phenotypic description and a discussion of genetic heterogeneity of these disorders, see EIG1 (600669), EJM1 (254770), and EJA1 (607631).
See: Condition Record
Epilepsy, idiopathic generalized, susceptibility to, 11
Epilepsy, idiopathic generalized, susceptibility to, 9
Epilepsy, juvenile absence, susceptibility to, 1

Professional guidelines

PubMed

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
Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice.
Roberson SW, Patel MB, Dabrowski W, Ely EW, Pakulski C, Kotfis K
Curr Neuropharmacol 2021;19(9):1519-1544. doi: 10.2174/1570159X19666210119153839. PMID: 33463474Free PMC Article
Genetic Landscape of Common Epilepsies: Advancing towards Precision in Treatment.
Thakran S, Guin D, Singh P, Singh P, Kukal S, Rawat C, Yadav S, Kushwaha SS, Srivastava AK, Hasija Y, Saso L, Ramachandran S, Kukreti R
Int J Mol Sci 2020 Oct 21;21(20) doi: 10.3390/ijms21207784. PMID: 33096746Free PMC Article

Recent clinical studies

Etiology

Epilepsy and Sleep in the ATR-X Syndrome.
Mierlo PV, Braakman H, Vandenbussche N, Schelhaas HJ, Pillen S
Neuropediatrics 2022 Apr;53(2):109-114. Epub 2021 Dec 21 doi: 10.1055/s-0041-1740551. PMID: 34933379
Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice.
Roberson SW, Patel MB, Dabrowski W, Ely EW, Pakulski C, Kotfis K
Curr Neuropharmacol 2021;19(9):1519-1544. doi: 10.2174/1570159X19666210119153839. PMID: 33463474Free PMC Article
Genetic Landscape of Common Epilepsies: Advancing towards Precision in Treatment.
Thakran S, Guin D, Singh P, Singh P, Kukal S, Rawat C, Yadav S, Kushwaha SS, Srivastava AK, Hasija Y, Saso L, Ramachandran S, Kukreti R
Int J Mol Sci 2020 Oct 21;21(20) doi: 10.3390/ijms21207784. PMID: 33096746Free PMC Article
Epileptology of the first tonic-clonic seizure in adults and prediction of seizure recurrence.
Koutroumanidis M, Bruno E
Epileptic Disord 2018 Dec 1;20(6):490-501. doi: 10.1684/epd.2018.1014. PMID: 30530414
Idiopathic generalized epilepsies of adolescence.
Beghi M, Beghi E, Cornaggia CM, Gobbi G
Epilepsia 2006;47 Suppl 2:107-10. doi: 10.1111/j.1528-1167.2006.00706.x. PMID: 17105478

Diagnosis

Epilepsy and Sleep in the ATR-X Syndrome.
Mierlo PV, Braakman H, Vandenbussche N, Schelhaas HJ, Pillen S
Neuropediatrics 2022 Apr;53(2):109-114. Epub 2021 Dec 21 doi: 10.1055/s-0041-1740551. PMID: 34933379
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
Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice.
Roberson SW, Patel MB, Dabrowski W, Ely EW, Pakulski C, Kotfis K
Curr Neuropharmacol 2021;19(9):1519-1544. doi: 10.2174/1570159X19666210119153839. PMID: 33463474Free PMC Article
Genetic Landscape of Common Epilepsies: Advancing towards Precision in Treatment.
Thakran S, Guin D, Singh P, Singh P, Kukal S, Rawat C, Yadav S, Kushwaha SS, Srivastava AK, Hasija Y, Saso L, Ramachandran S, Kukreti R
Int J Mol Sci 2020 Oct 21;21(20) doi: 10.3390/ijms21207784. PMID: 33096746Free PMC Article
Hypnopompic seizures.
Awad AM, Lüders HO
Epileptic Disord 2010 Dec;12(4):270-4. Epub 2010 Oct 29 doi: 10.1684/epd.2010.0336. PMID: 21030341

Therapy

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
Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice.
Roberson SW, Patel MB, Dabrowski W, Ely EW, Pakulski C, Kotfis K
Curr Neuropharmacol 2021;19(9):1519-1544. doi: 10.2174/1570159X19666210119153839. PMID: 33463474Free PMC Article
Clinical aspects of juvenile myoclonic epilepsy.
Genton P, Thomas P, Kasteleijn-Nolst Trenité DG, Medina MT, Salas-Puig J
Epilepsy Behav 2013 Jul;28 Suppl 1:S8-14. doi: 10.1016/j.yebeh.2012.10.034. PMID: 23756488
Ion channels and epilepsy.
Armijo JA, Shushtarian M, Valdizan EM, Cuadrado A, de las Cuevas I, Adín J
Curr Pharm Des 2005;11(15):1975-2003. doi: 10.2174/1381612054021006. PMID: 15974971
Juvenile myoclonic epilepsy.
Clement MJ, Wallace SJ
Arch Dis Child 1988 Sep;63(9):1049-53. doi: 10.1136/adc.63.9.1049. PMID: 3140737Free PMC Article

Prognosis

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
Genetic Landscape of Common Epilepsies: Advancing towards Precision in Treatment.
Thakran S, Guin D, Singh P, Singh P, Kukal S, Rawat C, Yadav S, Kushwaha SS, Srivastava AK, Hasija Y, Saso L, Ramachandran S, Kukreti R
Int J Mol Sci 2020 Oct 21;21(20) doi: 10.3390/ijms21207784. PMID: 33096746Free PMC Article
Pharmacological Management of the Genetic Generalised Epilepsies in Adolescents and Adults.
Stephen LJ, Brodie MJ
CNS Drugs 2020 Feb;34(2):147-161. doi: 10.1007/s40263-020-00698-5. PMID: 31983023
Epileptology of the first tonic-clonic seizure in adults and prediction of seizure recurrence.
Koutroumanidis M, Bruno E
Epileptic Disord 2018 Dec 1;20(6):490-501. doi: 10.1684/epd.2018.1014. PMID: 30530414
Critical Care Management after Cardiac Arrest.
Friberg H, Cronberg T
Semin Neurol 2016 Dec;36(6):542-549. Epub 2016 Dec 1 doi: 10.1055/s-0036-1592168. PMID: 27907958

Clinical prediction guides

Bidirectional relationships of sleep and epilepsy in adults with epilepsy.
Grigg-Damberger M, Foldvary-Schaefer N
Epilepsy Behav 2021 Mar;116:107735. Epub 2021 Feb 6 doi: 10.1016/j.yebeh.2020.107735. PMID: 33561767
Genetic Landscape of Common Epilepsies: Advancing towards Precision in Treatment.
Thakran S, Guin D, Singh P, Singh P, Kukal S, Rawat C, Yadav S, Kushwaha SS, Srivastava AK, Hasija Y, Saso L, Ramachandran S, Kukreti R
Int J Mol Sci 2020 Oct 21;21(20) doi: 10.3390/ijms21207784. PMID: 33096746Free PMC Article
Epileptology of the first tonic-clonic seizure in adults and prediction of seizure recurrence.
Koutroumanidis M, Bruno E
Epileptic Disord 2018 Dec 1;20(6):490-501. doi: 10.1684/epd.2018.1014. PMID: 30530414
Sleep and epilepsy syndromes.
Schmitt B
Neuropediatrics 2015 Jun;46(3):171-80. Epub 2015 May 12 doi: 10.1055/s-0035-1551574. PMID: 25965811
Hypnopompic seizures.
Awad AM, Lüders HO
Epileptic Disord 2010 Dec;12(4):270-4. Epub 2010 Oct 29 doi: 10.1684/epd.2010.0336. PMID: 21030341

Recent systematic reviews

The effectiveness of BIS monitoring during electro-convulsive therapy: A systematic review and meta-analysis.
Guerrier G, Gianni MA
J Clin Anesth 2019 Dec;58:100-104. Epub 2019 May 28 doi: 10.1016/j.jclinane.2019.05.006. PMID: 31151038

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