Grand mal seizure, also known as tonic-clonic seizure, is a neurological condition caused by abnormal electrical impulses throughout the cells of the brain. According to the Mayo Clinic, it results in symptoms of generalized loss of consciousness and total body convulsions and is what most people think of when considering epilepsy. Though some anticonvulsant medications may not work well for generalized conditions such as grand mal seizures, there are many choices for the treatment of grand mal epilepsy.
Phenytoin
Phenytoin is one of the oldest medications used for the treatment of many different types of epilepsy, including grand mal seizures, and may work by interfering with sodium channels in the brain. Phenytoin has a number of side effects, some of which may be troubling. Consequently, its use has largely been replaced by newer medications. It commonly causes side effects such as nausea, movement disorder and nystagmus or jerky eye movements. Long-term side effects may be unusual, including unwanted hair growth and overgrowth of the gums. Most patients will need occasional laboratory testing to check for appropriate blood concentration levels and to avoid toxicity.
Phenobarbital
Phenobarbital has been used for many years to treat a wide range of seizure disorders, including grand mal seizures, and works by increasing GABA in the brain to produce sedation. Though it works well and is occasionally used in adults, its use is now mostly in children and infants because it often produces sedation and may lead to mild dependence. Some patients may have difficulty with thinking and memory processes, and children should be carefully monitored to avoid an induced learning delay.
Valproic Acid
Valproic acid is used for a broad range of seizure disorders, including generalized tonic-clonic seizures in adults and children over three years of age and may work by interactions with GABA receptors and calcium channels. Side effects commonly seen may include drowsiness, stomach upset, weight gain and tremors. More serious side effects may include liver or pancreatic damage, changes in blood cell levels and bone loss. Patients taking valproic acid may need occasional blood tests to detect damage to these systems.
Topiramate
Topiramate may be used for epilepsy, including the treatment of grand mal seizures in both adults and children, and appears to work by blocking carbonic anhydrase activity within the brain. Common side effects may be problems with memory and thought processes, as well as drowsiness. Though rare, some patients may develop increased eye pressure or glaucoma, and changes in eyesight need immediate medical attention.
Lamotrigine
Lamotrigine is considered to be a broad-spectrum anti-convulsant medication that is often used as an alternative to valproic acid. It is also used as a mood stabilizer for bipolar disorder. Common side effects may include dizziness, headache, fatigue and rash. Any side effects that become severe or bothersome should be reported to a physician.
Levetiracetam
Levetiracetam is used for the adjunctive treatment of tonic-clonic seizures, meaning that it must be combined with another medication for grand mal seizures. Epilepsy.com states that it may commonly cause side effects such as fatigue, irritability and dizziness but is less likely to cause memory loss or foggy thinking than other medications.
