title: Concussive convulsions: A YouTube video analysis.
abstract: To analyze seizure-like motor phenomena immediately occurring after concussion (concussive convulsions).
  
  
  
  Twenty-five videos of concussive convulsions were obtained from YouTube as a result of numerous sports-related search terms. The videos were analyzed by four independent observers, documenting observations of the casualty, the head injury, motor symptoms of the concussive convulsions, the postictal period, and the outcome.
  
  
  
  Immediate responses included the fencing response, bear hug position, and bilateral leg extension. Fencing response was the most common. The side of the hit (p = 0.039) and the head turning (p = 0.0002) was ipsilateral to the extended arm. There was a tendency that if the blow had only a vertical component, the bear hug position appeared more frequently (p = 0.12). The motor symptom that appeared with latency of 6 ± 3 s was clonus, sometimes superimposed with tonic motor phenomena. Clonus was focal, focally evolving bilateral or bilateral, with a duration of 27 ± 19 s (5-72 s). Where lateralization of clonus could be determined, the side of clonus and the side of hit were contralateral (p = 0.039).
  
  
  
  Concussive convulsions consist of two phases. The short-latency first phase encompasses motor phenomena resembling neonatal reflexes and may be of brainstem origin. The long-latency second phase consists of clonus. We hypothesize that the motor symptoms of the long-latency phase are attributed to cortical structures; however, they are probably not epileptic in origin but rather a result of a transient cortical neuronal disturbance induced by mechanical forces.
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Dalma
authors.initials: D
authors.lastname: Tényi
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Csilla
authors.initials: C
authors.lastname: Gyimesi
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Réka
authors.initials: R
authors.lastname: Horváth
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.|PTE-MTA Clinical Neuroscience MR Research Group, Pécs, Hungary.
authors.forename: Norbert
authors.initials: N
authors.lastname: Kovács
authors.affiliation: Department of Medical Biology, University of Pécs, Pécs, Hungary.
authors.forename: Hajnalka
authors.initials: H
authors.lastname: Ábrahám
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.
authors.forename: Gergely
authors.initials: G
authors.lastname: Darnai
authors.affiliation: Epilepsy Center, Bethesda Children's Hospital, Budapest, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Fogarasi
authors.affiliation: Department of Neurosurgery, University of Pécs, Pécs, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Büki
authors.affiliation: Department of Neurology, University of Pécs, Pécs, Hungary.|PTE-MTA Clinical Neuroscience MR Research Group, Pécs, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Janszky
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004834:Epilepsy, Post-Traumatic / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D013997:Time Factors; D014741:Video Recording; D055815:Young Adult
keywords: Brain trauma; Concussive convulsion; Nonepileptic seizure; Seizure semiology