EPILEPSY
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EPILEPSY

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PEDODONTICS

PEDODONTICS

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    EPILEPSY EPILEPSY Presentation Transcript

    • GOOD MORNING !
    • EPILEPSY YASMIN MOIDIN 2008 Batch Al Azhar Dental College Thodupuzha
    • The epilepsies are a group of disorders characterized by chronic, recurrent and paroxysmal changes in neurologic function caused by abnormalities in the electrical activity of the brain
    •  Each episode of neurologic dysfunction is called a SEIZURE  The seizure may be accompanied by motor convulsive when manifestations or may be manifested by other changes in neurologic function
    • ETIOLOGY Epileptic disorders can occur due to :1. Idiopathic :- the condition cannot be attributed to any demonstrable lesion of the brain and is frequently of genetic origin 2. Symptomatic :- the condition is associated with the pathology of the brain due to developmental anomalies such as brain malformation, injury or disease such as fever, hypoxia, hypocalcaemia
    • CLASSIFICATION The International League against epilepsy has classified epileptic seizures as follows : PARTIAL SEIZURES • Simple partial seizures • Complex partial seizures • Secondary generalized seizures
    •  PRIMARY GENERALISED SEIZURES • Tonic clonic ( grand mal ) • Tonic • Absence ( petit mal ) • Atypical absence • Myoclonic • Atonic • Infantile spasms
    •  • • •  • • • STATUS EPILEPTICUS Tonic clonic status Absence status Epilepsia partialis continua RECURRENT PATTERNS Sporadic Cyclic Reflex
    • SIMPLE PARTIAL SEIZURE     Consciousness is fully preserved Motor, sensory, autonomic or psychic symptoms Jacksonian march Todd’s paralysis- lasts for minutes to hours
    • COMPLEX PARTIAL SEIZURE     Consciousness is impaired in the form of transient impairment in the patients ability to maintain normal contact with the environment Aura ( simple partial seizure) Automatisms- lip smacking, chewing, swallowing , picking movements of the hand Confused following seizure
    • PARTIAL SEIZURE WITH SECONDARY GENERALIZATION  Starts with partial seizure & then becomes generalized
    • ABSENCE SEIZURE  Sudden cessation of the ongoing conscious activity without convulsive muscular activity or loss of postural control  Lasts for a few seconds to minutes  Occurs in children of 6 to 14 years  Brief lapses of consciousness or awareness
    • TONIC CLONIC SEIZURE         Sudden loss of consciousness Tonic contraction of muscles Loss of postural control Respiration arrests Pupils dilate After 10 to 30 seconds – tonic phase – clonic phase – muscles contract – salivation – perspiration – involuntary bladder – bowel evacuation Contractions become less violent and gradually cease Child then remains stuporous and goes into deep
    • ORAL MANIFESTATIONS • • • • • • • • • Soft tissue lacerations of tongue or buccal mucosa Facial fractures Trauma to teeth Subluxation of the TMJ Injuries due to drug therapy Gingival hyperplasia Recurrent aphthous like ulceration Anomalous dental development Cervical lymphadenopathy
    • DENTAL MANAGEMENT       Complete medical history Reduce stress on patients Diazepam Use of dental chair light is avoided Avoid seizure promoting drugs Drug therapy :- vigabatrin, lamotrigine and topiramate
    • OFFICE MANAGEMENT OF SEIZURE  • • • • • • If seizure occurs in dental chair – Chair is lowered to supine position – Patient is protected from injuring himself – Mouthprop is inserted into oral cavity to prevent tongue biting Maintain a patent airway Diazepam 1mg per kg IV slowly upto 10mg Give oxygen
    • DENTAL TREATMENT  Appointments should be kept short  Importance of tooth brushing procedures and regular dental review is required  If appliances are indicated for tooth movement and tooth replacement , the fixed type are preferred