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WHAT: Seizure. Seizure: a paroxysmal transient disturbance of brain function that may be manifested as episodic impairment or loss of consciousness, abnormal motor phenomena, psychic or sensory disturbance or perturbation of the autonomic brain electrical activity. WHY: Seizures may occur in systemic lupus erythematosus or in necrotizing vasculitides such as polyarteritis, eosinophilic granulomatous vasculitis, aortic arch arteritis, or rheumatoid arteritis. HOW: A seizure probably exists when there are generalized convulsions or focal motor/sensory phenomenon. GENERALIZED CONVULSIONS may be preceded by an aura but usually have a sudden loss of consciousness with generalized muscle rigidity then generalized muscle activity. They may have incontinence of urine or feces or laceration of the tongue or buccal mucosa. This usually is followed by flaccidity, drowsiness, or complaints of a headache or sore muscles. FOCAL MOTOR/SENSORY PHENOMENON may precede generalized convulsions but may be tonic or clonic muscle activity that is limited to one extremity, one side of the body, or one side of the face or lateralized/localized sensory sensations. These may only be brief sudden involuntary muscle contractions associated with transitory loss of muscle tone and a brief loss of contact with the environment, repetitive automatic behavior patterns, feelings of familiarity or unfamiliarity associated with compulsive thinking, unpleasant epi- gastric sensations that may radiate to the head, or hallucinations of an auditory, vertiginous, olfactory, gustatory, or visual type. REFS: 1) Steinberg, AD: \'Management of Systemic Lupus Erythematosus\'. In Textbook of Rheumatology (Ch. 70). Philadelphia: W.B. Saunders Co., 1981. 2) Hunder, GG and Conn, DL: \'Necrotizing Vasculitis\'. In Textbook of Rheumatology (Ch. 72). Philadelphia: W.B. Saunders Co., 1981. 3) Harris, ED Jr: \'Pathogenesis of Rheumatoid Arthritis\'. In Textbook of Rheumatology (Ch. 59). Philadelphia: W.B. Saunders Co., 1981. 4) Bennet, RM and Spargo, BH: Neuropsychiatric problems in mixed connective tissue disease. Am J Med 65(6), December 1978, pp. 955-62. DN19307-1. 5) Duman, S and Ginsburg, S: \'Epilepsy (Seizures)\'. In Problem- Oriented Medical Diagnosis (Ch. 10). Boston: Little, Brown and Co., 1975.
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