Epilepsy: Grand Mal Seizure

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Epilepsy. In epilepsy, the grand mal seizure often begins with a sudden loss of consciousness and fall to the ground. The initial motor signs are a brief flexion of the trunk, an opening of the mouth and eyelids, and upward deviation of the eyes. The arms are elevated and abducted, the elbows semiflexed, and the hands pronated. These are followed by a more protracted extension phase, involving first the back and neck, then the arms and legs. There may be piercing cry as the whole musculature is seized in a spasm and air is forcibly emitted through the closed vocal cords. Since the respiratory muscles are caught up in the tonic spasm, breathing is suspended, and after some seconds, the skin and mucous membranes become cyanotic. The pupils are

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