April 06, 2014

Four stages of convulsion or fits

Eclamptic convulsion or fits are epileptiform and consist of four stages :

Premonitory stage -

The patient becomes unconscious. There is twitching of the muscles of the face, tongue and limbs. Eye ball roll or are turned to one side and become fixed. This stage lasts for about 30 seconds.

Tonic stage -

The whole body goes into a tonic spasm - the trunk-opisthotonus, limbs are flexed and hand clenched. Respiration ceases and the tongue protrudes between the teeth. Cyanosis appears. Eye balls become fixed. This stage lasts for about 30 seconds.

Clonic stage - 

All the voluntary muscles undergo alternate contraction and relaxation. The twitchings start in the face then involve one side of the extremities and ultimately the whole body is involved in the convulsion. Biting of the tongue occurs. Breathing is stertorous and blood stained frothy secretions fill the mouth. Cyanosis gradually disappears. This stage lasts for 1-4 minutes.

Stage of coma -

Following the fit, the patient passes on to the stage of coma. It may last for a brief period or in others deep coma persists till another convulsion. On occasion, the patient appears to be in a confused state following the fit and fails to remember the happenings. Rarely, the coma occurs without prior convulsion.


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