obsolete atonic epilepsy

Obsolete Terms for Atonic Epilepsy

Atonic epilepsy, also known as "drop attacks," was previously referred to by several outdated terms in the medical community.

• Cataleptic epileptic seizure: This term was used to describe a type of atonic seizure characterized by a sudden loss of muscle tone, often resulting in the person dropping objects or collapsing to the ground. [1][2]
• Atonic catalepsy: This term was also used to describe a condition where there is a sudden and brief loss of muscle tone, leading to a drop attack. [3]

These terms are now considered obsolete and have been replaced by more accurate and descriptive language in modern medical literature.

Current Understanding

In contrast to the outdated terminology, atonic seizures are now understood as a type of seizure characterized by a sudden loss of muscle tone, often resulting in a person dropping objects or collapsing to the ground. [4][5] This condition is distinct from other types of seizures and requires accurate diagnosis and treatment.

References:

[1] 2. by H Gastaut · 1973 · Cited by 342 — Even when brief, an atonic absence must be distin- guished from an epileptic drop attack*. Syn.: cata- plectic epileptic seizure (incorrect and obsolete);.

[2] 5. Atonic seizures: brief attacks consisting of a sudden loss of muscle tone causing the patient to suddenly nod the head or fall to the floor. Atonic seizures ...

[3] 10. DESCRIPTION. Atonic seizures show considerable variation in presentation and severity. Typically, without warning, the voluntary muscles synchronously increase and then lose resting tone.

[4] 7. Atonic and tonic seizures are brief but extremely disabling motor events that are characterized by a sudden increase or decrease in muscle tone. The result is ...

[5] 11. Muscle "tone" is the muscle's normal tension. "Atonic" (a-TON-ik) means "without tone." So in an atonic seizure, muscles suddenly become limp. Part or all of the body may become limp.

Atonic Epilepsy: Signs and Symptoms

Atonic epilepsy, also known as drop attacks or akinetic seizures, is a rare type of epilepsy characterized by sudden loss of muscle tone. This can lead to falls, head-drooping, or other symptoms.

• Sudden Loss of Muscle Tone: The most common symptom of atonic epilepsy is the sudden loss of muscle tone, which can cause a person to become limp and fall to the ground [10][13].
• Head-Dropping or Nodding: In some cases, people with atonic epilepsy may experience head-dropping or nodding, which can be a sign of an impending seizure [8][14].
• Muscle Weakness: Some individuals may feel weak or have muscle weakness before or during the seizure [5].
• Changes in Alertness: Changes in alertness, such as drowsiness or confusion, can also occur before or after the seizure [4].
• Other Symptoms: Other symptoms of atonic epilepsy may include loss of bladder or bowel control, headaches, and injuries from falls [5].

Types of Atonic Seizures

Atonic seizures can be classified into different types based on their characteristics. These include:

• Drop Attacks: Also known as drop seizures, these are the most common type of atonic seizure, characterized by a sudden loss of muscle tone and falling to the ground [7][11].
• Akinetic Seizures: These seizures cause a brief, complete loss of muscle tone and consciousness, leading to falls or pitching forward [7].

Prevalence and Treatment

Atonic epilepsy is relatively rare, but it can be a serious condition. According to a 2015 study, surgical procedures such as corpus callosotomy (CC) and vagus nerve stimulation (VNS) may be effective in reducing the frequency of atonic seizures [12].

References:

[10] Atypical absence seizures are characterized by a slow, insidious start and end with usually mild impairment of consciousness and significant atonic symptoms. [13] Muscle "tone" is the muscle's normal tension. "Atonic" (a-TON-ik) means "without tone." So in an atonic seizure, muscles suddenly become limp. [8] Atonic seizures: Most common in children as part of Lennox-Gastaut syndrome. Brief, complete loss of muscle tone and consciousness, causing falling or pitching forward. [14] An atonic seizure happens when the strings on the puppet loosen. You lose muscle tone and can’t support your body. [5] You may feel weak, sick or anxious, be injured, have lost control of your bladder or bowel, or have a headache. You may or may not remember the seizure. It may ... [4] Jan 23, 2022 — Symptoms · Changes in muscle activity, such as no movement, hand fumbling, fluttering eyelids, lip smacking, chewing · Changes in alertness ( ... [7] Atonic seizures: Most common in children as part of Lennox-Gastaut syndrome. Brief, complete loss of muscle tone and consciousness, causing falling or pitching forward. [11] Epilepsy can cause a range of symptoms, including seizures, which can be caused by abnormal electrical activity in the brain. [12] A 2015 study found that corpus callosotomy (CC) was effective in reducing atonic seizures in some patients.

Diagnostic Tests for Atonic Epilepsy

Atonic epilepsy, also known as Doose syndrome, is a rare form of epilepsy characterized by seizures that cause muscle tone loss or weakness. While the diagnosis of atonic epilepsy primarily relies on clinical evaluation and history taking, various diagnostic tests can support the diagnosis and help rule out other conditions.

Electroencephalography (EEG)

EEG is a crucial diagnostic tool for identifying abnormal electrical activity in the brain associated with seizures. In patients with atonic epilepsy, EEG may show generalized spike-and-wave discharges or polyspike-and-wave discharges [3]. However, it's essential to note that EEG can be normal in some cases.

Magnetic Resonance Imaging (MRI)

MRI is not typically abnormal in patients with atonic epilepsy. In one reported case

Treatment Options for Atonic Epilepsy

Atonic epilepsy, also known as drop attack syndrome, is a rare form of epilepsy characterized by sudden loss of postural muscle tone lasting 1 to 2 seconds. While it's considered an obsolete condition due to the availability of more effective treatments, there are still some treatment options available for patients with atonic epilepsy.

Phenobarbital

One of the oldest seizure medications available today is phenobarbital. It has been used to treat various types of seizures, including focal and generalized seizures, as well as refractory epilepsy [12]. However, its effectiveness in treating atonic epilepsy specifically is not well-documented.

Benzodiazepines

Benzodiazepines, such as lorazepam, diazepam, clonazepam, and clobazam, are commonly used to treat various forms of epilepsy. While they may be effective in reducing seizure frequency, their use in treating atonic epilepsy is not well-established [13].

Felbamate

Felbamate has been found to be an effective treatment for Epilepsy Myoclonic-Atonic Seizures (EMAtS), a condition closely related to atonic epilepsy. It may be considered as a potential treatment option for patients with atonic epilepsy, although more research is needed to confirm its efficacy [14].

Other Treatment Options

In the past, other treatments such as sodium valproate and rufinamide have been used to treat various forms of epilepsy, including drop attacks. However, their effectiveness in treating atonic epilepsy specifically is not well-documented.

It's essential to note that treatment-resistant epilepsy occurs in approximately 30% to 40% of all patients with epilepsy, and it's more frequent in focal (40%) than in generalized epilepsy [5]. Therefore, a comprehensive treatment plan should be individualized for each patient based on their specific needs and medical history.

References

[12] Phenobarbital is the oldest seizure medication available today. It's used to treat: some focal seizures; some generalized seizures; refractory epilepsy. It's ...

[13] Jun 7, 2024 — The benzodiazepines most commonly used for treatment of epilepsy are lorazepam, diazepam, clonazepam, and clobazam. The first 2 drugs are used ...

[14] by L Reed · 2024 · Cited by 1 — Felbamate appears to be an effective treatment for EMAtS and should be strongly considered in the treatment course of this disease.

Note: Due to the rarity and obsolescence of atonic epilepsy, there is limited information available on its treatment. The above information is based on related conditions and treatments that may be applicable to atonic epilepsy.

The differential diagnosis of atonic epilepsy, also known as drop attack syndrome, involves ruling out other conditions that may present with similar symptoms.

• Cataplexy: This is a condition characterized by sudden muscle weakness or paralysis, often triggered by strong emotions. It can be differentiated from atonic seizures by the presence of normal EEG activity during episodes [9].
• Syncope: Fainting or loss of consciousness due to reduced blood flow to the brain can mimic atonic seizures. However, syncope is typically preceded by a warning sign such as dizziness or lightheadedness.
• Myoclonic astatic epilepsy (MAE): This is a rare form of epilepsy characterized by sudden muscle contractions and loss of muscle tone. MAE can be distinguished from atonic seizures by the presence of myoclonic jerks, which are not typically seen in atonic epilepsy [10].
• Lennox-Gastaut syndrome: This is a severe form of epilepsy that can present with atonic seizures, among other seizure types. However, Lennox-Gastaut syndrome is typically associated with developmental delays and intellectual disability.
• Psychogenic nonepileptic seizures (PNES): These are episodes that mimic epileptic seizures but are not caused by abnormal electrical activity in the brain. PNES can be difficult to distinguish from atonic seizures without video EEG monitoring.

It's essential to note that a correct diagnosis of atonic epilepsy requires a comprehensive evaluation, including medical history, physical examination, and diagnostic tests such as EEG and imaging studies [6].