EPILEPSY

■ - also known as “seizure disorder”

TYPES OF SEIZURES

■ Tonic Clonic Seizures (Grand mal) - have a typically rapid onset and are preceded by
momentary aura (a feeling, experience or movement that just seems different)

■ Absence Seizures (Petit mal) – usually appear between 3 years of age and puberty

■ Generalized status epilepticus – a single seizure lasting for at least 20 minutes or recurrent
generalized seizures without the regaining of consciousness between the seizure episode

CLINICAL SIGNS AND SYMPTOMS

GENERAL MANIFESTATION

Grand mal convulsion

– excessive muscular activity
– loss of consciousness
– muscle rigidity
– patient may become apneic

after the attack patient may:

– fall into an exhaustive sleep
– exhibit headache
– vomiting
– muscle soreness

GENERAL MANIFESTATION

Petit mal convulsion

– loss of consciousness
(predominant symptom)

– eyelids, and sometimes the head, move synchronously

the seizure lasts only a short while (seconds)

– patient usually reacts without aftereffects

ORAL MANIFESTATION

Grand mal convulsion

ORAL MANIFESTATION

Petit mal convulsion

MEDICATIONS
 ■ Epileptic seizures often can be eliminated or alleviated by antiepileptic drugs, such as phenytoin,
carbamazepine, and valproate sodium

■ An implantable device that stimulates the vagus (X) nerve has produced dramatic results in
reducing seizures

■ In very severe cases, surgical intervention may be an option

DENTAL MANAGEMENT

Management of grand mal

1. Terminated procedure- remove instruments and dental appliances from patient/client’s mouth.
2. Position the patient supine with legs elevated- turn patient onto his/her side to minimize
aspiration of secretions. Place nothing in mouth or between teeth- loosen tight clothing
3. Time the seizure.
4. Summn medicalassistance call 911 if the seizure lasts longer than 3 minutes or the patient
becomes cyanotic from the onset.
5. Assess and perform, when necessary, basic life support- perform head tilt chin lift to maintain
airway-protect patient from injury.
6. After seizure, reaasure patient and allow him/her to recover-assess oral cavity for injury to teeth
and tissues
7. Discharge patient to hospital, physician or home with a responsible adult.