Secondarily generalized tonic-clonic seizures

Historical note and nomenclature
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By Robert L Beach MD PhD and Rajdeep Singh MD

The earliest descriptions of tonic-clonic seizures appear in Egyptian hieroglyphics prior to 700 BC (Fisch 2006). Partial-onset seizures were described by Bravais in his 1827 thesis. He reported 3 modes of somatic onset (facial, brachial, and crural) and detailed their progression before loss of consciousness to tonic-clonic generalized seizures (Bancaud and Talairach 1992). Herpin studied the semiology of patients with partial epilepsies and tried to describe seizures from an anatomical-physiological perspective (Herpin 1867). He mentioned aura as the first manifestation of the convulsive attack and considered the 2 periods (tonic and then clonic) as indistinct.