Epilepsy_S24 PDF - Dental Treatment Modifications

Mechanism of Neuronal Excitability Neuron depolarization triggered by sodium ion influx → generates action potential. EPILEPSY Treatment for Epilepsy...

Mechanism of Neuronal Excitability Neuron depolarization triggered by sodium ion influx → generates action potential. EPILEPSY Treatment for Epilepsy The most common treatment for epilepsy are Anti-Epileptic drugs Action potential opens calcium channels at axon terminal → calcium influx. Epilepsy is a (AEDs) like benzodiazepines, Calcium causes neurotransmitter release into synaptic common and which get into the bloodstream cleft. serious quickly to prevent the brain from Neurotransmitters bind to receptors on next neuron → seizing. may initiate new action potential. neurological condition that Some types you may have heard of: Causes of Seizures affects the brain Genetic factors: inherited predisposition. - Lorazepam and causes - Diazepam Structural brain abnormalities: tumors, scar tissue. Other triggers: stroke, infections (e.g., meningitis), frequent - Clorazepam traumatic brain injury. seizures (NHS, Metabolic imbalances: hypoglycemia, electrolyte 2020). disturbances. Dental Treatment Modifications Dental Implications Appointment Timing Pre-Appointment Oral Trauma - Medical History and Environment Local Anaesthetic - Appointment Timing -Soft tissue damage - Medication -Correct injection site - Quiet, Low-stress -Attrition Schedule -Aspiration techniques Environment -TMJ damage -Limit dose - Shorter Appointments -Fractured / avulsed teeth Patient Susceptibility Treatment Conditions Medical Emergency Medication Side-effects -Poor oral hygiene - Chairside positioning Plan -Xerostomia -Periodontal disease - Sharp Instruments in - Seizure Protocol -Gingival Hyperplasia -Caries mouth -Emergency kit/drugs -Acid reflux -Oral infections - Mouth prop -Post-Seizure Care - Continuous Monitoring  References Ashley, K. and Lui, F. (2020). Physiology, Nerve. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK551652/. Bromfield, E.B., Cavazos, J.E. and Sirven, J.I. (2015). Basic Mechanisms Underlying Seizures and Epilepsy. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK2510/. Carter, E.L. and Adapa, R.M. (2015). Adult epilepsy and anaesthesia. BJA Education, [online] 15(3), pp.111–117. doi:https://doi.org/10.1093/bjaceaccp/mku014. Delanty, N., Vaughan, C.J. and French, J.A. (1998). Medical causes of seizures. The Lancet, [online] 352(9125), pp.383–390. doi:https://doi.org/10.1016/s0140- 6736(98)02158-8. Fazal, A., Rafeeq, M. and Dubey, A. (2014). Assessment of Oral Side Effects of Antiepileptic Drugs and Traumatic oro-facial Injuries Encountered in Epileptic Children. Journal of International Oral Health : JIOH, [online] 6(2), p.126. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4037794/ [Accessed 1 Nov. 2024]. Goswami, M., Johar, S. and Khokhar, A. (2023). Oral Health Considerations and Dental Management for Epileptic Children in Pediatric Dental Care. International Journal of Clinical Pediatric Dentistry, [online] 16(1), pp.170–176. doi:https://doi.org/10.5005/jp-journals-10005-2516. Huff, J.S. and Murr, N. (2022). Seizure. [online] PubMed. Available at: https://pubmed.ncbi.nlm.nih.gov/28613516/. Jahromi, S.R., Togha, M., Fesharaki, S.H., Najafi, M., Moghadam, N.B., Kheradmand, J.A., Kazemi, H. and Gorji, A. (2011). Gastrointestinal adverse effects of antiepileptic drugs in intractable epileptic patients. Seizure, [online] 20(4), pp.343–346. doi:https://doi.org/10.1016/j.seizure.2010.12.011. Joshi, N.H., Deshpande, A.N., Deshpande, N.C. and Rathore, A.S. (2017). Comparative Evaluation of Oral Hygiene Status and Gingival Enlargement among Epileptic and Healthy Children as Related to Various Antiepileptic Drugs. Journal of Indian Society of Periodontology, [online] 21(2), pp.125–129. doi:https://doi.org/10.4103/jisp.jisp_48_17. NHS (2020). Epilepsy. [online] NHS. Available at: https://www.nhs.uk/conditions/epilepsy/ [Accessed 20 Nov. 2024].