Epilepsy, a Neurological Emergency in Oro-maxi-facial Surgery - neuro - psychic Field (original) (raw)
Related papers
Management of Epileptic Patient in an Orthodontic Clinic
Research Reviews Journal of Dental Sciences, 2014
Seizure disorders are the most common serious chronic neurological condition. This review is intended to update the orthodontist regarding seizure disorders including etiology, medical and surgical management, impact on dental health, potential for altering orthodontic treatment planning and delivery, and guidelines for management of seizures in the orthodontic office. It is estimated that there are 55,00,000 persons with epilepsy in India, 20,00,000 in USA and 3,00,000 in UK. The majority of patients can be managed medically so that they remain free of seizures. Contemporary management may include medications, surgery, an implanted nerve-stimulation device, and/or a ketogenic diet. Considerations for the orthodontist planning treatment for a patient with a seizure disorder are specific details about seizure onset, frequency, and type, behavior during seizures, duration, triggers, recovery period, medical management, and compliance. Patients with epilepsy and a malocclusion should have a comprehensive orthodontic evaluation. Adverse side effects of Anti-Epileptic Drugs (AEDs) and past dental trauma should be researched by the orthodontist and reviewed as part of patient informed consent. The practitioner and staff should be prepared to recognize and respond appropriately when a patient has a seizure in the orthodontic office.
Refractory epilepsy is highly associated with severe dentoalveolar and maxillofacial injuries
2011
Background Dental intrusion and avulsion, crown fracture and mandibular fractures are important dentofacial complications in patients with epilepsy-related traumas. The objective of the present study was todescribe the occurrence of orofacial injuries in patients with epilepsy. Materials and methods One hundred and nine consecutive patients (60 women; mean age 38.81±14 years), treated for refractory epilepsy (45 with extratemporal epilepsy and 64 with temporal epilepsy) at the outpatient clinic of our University Hospital, were included in the present study. Orofacial injury occurring as a direct result of a seizure was determined by clinical examination and interview. In addition, seizure frequency, use of medication, and the occurrence and type of injury to other parts of the body, were documented. We employed regression analyses to investigate the association between teeth fractures and frequency of seizures. Results The majority of injuries were crown fractures (42 subjects), followed by mandibular fractures (eight subjects) and tooth avulsion (eight subjects). Sixteen patients had more than two fractured teeth. Patients with mandibular trauma also suffered concomitant injuries (teeth fracture, avulsion and dislocation). The number of fractured teeth was associated with seizure frequency (r2 = 0.59, p<0.001). The data suggest that there is an increased rate of dentoalveolar and maxillofacial injuries in patients with poorly controlled epileptic seizures.
Oro-dental and maxillofacial trauma in epilepsy at a tertiary hospital in Lagos
West African journal of medicine
Seizure-related injuries are common and are a major cause of morbidity in subjects with epilepsy. To determine the frequency and types of oro-facial injuries in epileptic patients attending a tertiary hospital. A structured questionnaire was used to obtain information about injuries to the oral and maxillofacial region in epileptic patients at the Neurology Clinic of the Lagos University Teaching Hospital over a period of two years. Information sought included patient's sociodemographics, type of seizure, self-management of seizures, and history of injuries during seizures. Of the 138 epileptic patients seen, 87 (63.0%) reported the occurrence of oral and maxillofacial injuries. Mean age of these patients (29.6±12.1 years) was not significantly different from that of those who had no injuries (33.5±15.6 years). Prevalence of seizure-related injuries was not significantly different in males and females (50 [58.8%] vs 37 [71.2%]). Injuries were more likely in those who had convuls...
Oral Health Considerations and Dental Management for Epileptic Children in Pediatric Dental Care
International Journal of Clinical Pediatric Dentistry, 2023
psychic seizures, and autonomic seizures. Complex partial seizures are of two types-seizure with simple partial-onset, after which awareness is impaired, and seizure in which awareness is impaired at the onset of a seizure. In simple partial seizures, consciousness is not impaired, and only part of the cortex is disrupted by the seizure. In complex partial seizures, the memory associated with partial seizures is lost, and the partial seizure develops into a secondary generalized seizure later on. Generalized seizures usually lead to loss of consciousness, and convulsions can or might not occur. Generalized seizures have the following subtypes-absence, generalized myoclonic tonic-clonic, and atonic. Absence seizures, also known as petit mal seizures, are characterized by staring without any reaction to an external verbal stimulus with the blinking of eyes or nodding of the head. Generalized tonic-clonic seizures [formerly called grand mal (GTCS)] involve bilateral symmetric convulsive movements in which muscles stiffen, followed by jerking of all limbs along with impaired consciousness. IntroductIon According to World Health Organization (WHO), epilepsy is defined as a chronic association of multiple etiologies which involves recurring episodes of paroxysmal brain dysfunction, which occur due to sudden disorder and excessive neuronal discharge. 1 Epilepsy is characterized by seizures along with certain features such as altered perception, behavior, and mental activities, involuntary muscle contractions, transient loss of consciousness, and chronic changes in neurological functions. Epileptic seizures are reversible and have a tendency to recur. 2-4 Seizures can be defined as the discontinuation of normal brain functions due to excessive or inadequate electrical discharges, which occur suddenly and result in episodic convulsions with certain other features, such as involuntary movements, altered consciousness, or disturbed perception. 5,6 The occurrence of atleast two or more seizure episodes is necessary for the diagnosis of epilepsy. 7 A total of 50 million people worldwide are suffering from epilepsy (WHO). 1 The incidence of epilepsy in the pediatric population varies from 41 to 187 cases/100,000 children. The prevalence of epilepsy in children ranges from 3.2 to 5.5/1,000 in developed countries and 3.6-44/1,000 in underdeveloped countries. 8 About 25% of cases of epilepsy occur due to brain damage caused by infection, injury, cerebrovascular accident, or birth trauma. Idiopathic epilepsy involves the remaining 75% of cases for which there are no identifiable causes (Table 1). 3 The etiology of epileptic seizures depends upon the individual seizure threshold, which is genetically determined and it interacts with the precipitating factors or triggers (Table 2). Seizures are classified into three categories-focal (formerly called partial), followed by lethargy and confusion. Aberrant neuronal activity is more widespread in generalized seizures. In 30% of patients with generalized and unclassified (Table 3). Focal/partial seizures are further of two types-simple and complex. Simple partial seizures are divided into motor seizures, sensory seizures,
Polish Journal of Public Health, 2014
Introduction. One of the indications for dental treatment in general anaesthesia of children and adolescents is the patients’ refusal to cooperate with the dentist; this concerns especially the so-called special care patients, and among them, those suffering from epilepsy. Aim. The aim of the study was to evaluate the structure of treatment procedures in conservative dentistry and dental surgery performed under general anaesthesia in children and adolescents with epilepsy. Material and methods. The analysis covered case histories of 109 patients with epilepsy, aged 3-18 years, who received dental treatment under general anaesthesia. The patients were divided into three age groups, according to the dentition type: patients with deciduous dentition - 3-5 years of age; with mixed dentition - 6-12 years, and with permanent dentition - 13-18 years. The analysis concerned the procedures on both deciduous and permanent teeth. Results. An average number of extractions in a child with full d...
Case Report: Occult Maxillofacial Trauma in Epilepsy
The Journal of Contemporary Dental Practice, 2001
Epilepsy is a relatively common neurological disorder with incidence in both developed and developing countries. Head, facial, and oral injuries can result from seizures experienced by the epileptic patient. Patients with severe epilepsy often experience other dental disease due to their inability to properly maintain their oral hygiene. This paper presents a case of a chronic mandibular fracture following an episode of seizures in a patient with epilepsy in whom the fracture was discovered when he developed a fistula in the submandibular region. Citation Aragon CE, Burneo JG, Helman J. Occult Maxillofacial Trauma in Epilepsy. J Contemp Dent Pract 2001 Nov;(2)4: 026-032.
International Dental Research
Aim: In our study, we investigated the effects of local anesthesia on pediatric epileptic patients’ vital signs (temperature, oxygen saturation, pulse, and blood pressure) before, during, and after application. Methodology: Epileptic patients needing dental treatment who applied to the Department of Pedodontics in the Faculty of Dentistry at Necmettin Erbakan University between January 2021 and July 2022 were included in the study. After clinical and radiographic examination, Necmettin Erbakan University Meram Medical Faculty Pediatric Neurology Department was sent for consultation. Temperature, oxygen saturation, pulse, and blood pressure data were collected before, during, and after anesthesia in 39 procedures performed on 19 patients. Before data analysis, the Kolmogorov–Smirnov and Shapiro–Wilk tests were applied to test the normality of distribution. A paired sample t-test was used to examine the fever, pulse, blood pressure, and oxygen saturation levels of the participants bef...
European Archives of Paediatric Dentistry, 2009
AIM: To investigate the oral health of children with intractable epilepsy attending the UK National Centre for Young People with Epilepsy. STUDY DESIGN AND METHODS: 39 children and adolescents with intractable epilepsy at a residential school, the UK National Centre For Young People With Epilepsy (NCYPE) were age, gender and ethnicity matched with 39 healthy children from local schools in Surrey (England). Dental examinations were completed for indices for both the primary and permanent dentitions comprising decayed, missing and filled teeth and surfaces, plaque index, gingivitis index, developmental enamel defects, and incisor tooth trauma. RESULTS: There was no significant difference in the dmfs, dmft, DMFS or DMFT in the children with epilepsy compared with the controls. There was a significantly greater mean plaque score associated with permanent teeth in the children with epilepsy 68.0 SD± 31.5, compared with the control children, 142.9 SD± 23.2, p < 0.0001. The mean ± SD gingivitis score was significantly greater in the children with epilepsy 47.9±33.8, compared with the control children, 15.85±21.8, p < 0.001. A significantly greater number of children with epilepsy had experienced anterior tooth trauma, 54% in all, compared with the controls, 12.5% p < 0.0001. Although children with epilepsy had greater mean plaque and gingivitis scores, the prevalence of dental caries was low. Children and teenagers with intractable epilepsy were more likely to have sustained dental trauma than controls. CONCLUSIONS: A dental service aimed at early attention to anterior tooth trauma is needed. In addition, there is an ongoing need for improving the oral hygiene of these individuals to prevent the development of periodontal disease in later life.