convulsions

Japanese: 痙攣

Convulsions are involuntary, paroxysmal contractions of muscles in the whole body or in parts of the body. Lesions that cause convulsions include the brain, spinal cord, peripheral nerves, and muscles, and can occur due to abnormalities at any neuromuscular level. Furthermore, the pathological conditions that cause convulsions are diverse, including organic lesions such as inflammation, infection, tumors, and vascular disorders, electrolyte and metabolic abnormalities, and cerebral circulatory disorders (Table 2-49-1).
Convulsions are often used to mean generalized convulsive seizures. The causes of generalized convulsive seizures include acute symptomatic convulsive seizures caused by acute brain or metabolic disorders, and epileptic seizures caused by chronic diseases. Convulsions may be caused by brain diseases, or may be seen as a symptom of a systemic disease (pathology). Convulsions are a typical type of epileptic seizure, but epilepsy can have seizures that cause convulsions and those that do not (absence seizures, complex partial seizures). Convulsions are also a general term, and the "convulsions" that patients complain of include a variety of symptoms such as epileptic seizures, involuntary movements, and painful muscle spasms. Differential diagnoses of convulsions include muscle spasms, tetanus, stiff-person syndrome, painful tonic tetany, hemifacial spasms, tics, and convulsive syncope. So-called hysterical seizures can also cause convulsive seizures. Seizures caused by psychological factors are called non-epileptic psychogenic seizures (NEPS). [Naoki Akamatsu and Sadatoshi Tsuji]
【⇨15-1】

Table 2-49-1
Major diseases that cause generalized convulsions

Table 2-49-1

Source : Internal Medicine, 10th Edition About Internal Medicine, 10th Edition Information

Japanese:

痙攣は全身または身体の一部の筋群の不随意で発作性の収縮である．痙攣の原因となる病変部位としては，脳，脊髄，末梢神経，筋肉であり，神経-筋のどのレベルの異常でも起こりうる．また痙攣の原因となる病態は，炎症・感染，腫瘍，血管障害といった器質病変，電解質・代謝異常，脳循環障害など多岐にわたる（表2-49-1）．
　痙攣は全身痙攣発作の意味でよく使われる．全身痙攣発作の病因には，急性の脳障害・代謝障害などに起因する急性症候性痙攣発作（acute symptomatic convulsive seizure）と，慢性疾患のてんかん発作（epileptic seizure）がある．痙攣の原因が脳疾患のこともあれば，全身性疾患（病態）の一症状として痙攣がみられることがある．　痙攣は代表的なてんかん発作型ではあるが，てんかんには痙攣をきたす発作と，きたさない発作（欠神発作，複雑部分発作）がある．痙攣は一般用語でもあり，患者の訴えの「痙攣」はてんかん発作，不随意運動，有痛性の筋痙攣など多彩な症状が含まれる．　痙攣の鑑別には，筋痙攣，破傷風，全身硬直（stiff -person）症候群，有痛性強直発作テタニー，半側顔面痙攣，チック，痙攣性失神，も含まれる．いわゆるヒステリー発作も痙攣発作をきたす．精神的な要因による痙攣発作で，非てんかん性心因性発作（non-epileptic psychogenic seizure：NEPS）とよばれる．［赤松直樹・辻　貞俊］
【⇨15-1】

表2-49-1
全身痙攣の原因となるおもな疾患">

表2-49-1

出典　内科学第10版内科学第10版について　情報

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