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Epilepsy/Epileptic Seizures - Coggle Diagram
Epilepsy/Epileptic Seizures
Etiology of seizures
Infection
Trauma
Toxicity to exogenous agents
Genetic or birth defect
Circulatory disturbances
Metabolic or nutritional alterations
Neoplasms
Hereditary factors
Fevers
Degenerative diseases
Idiopathic
Types of seizures
Partial
Involve one hemisphere of the brain
complex partial seizure
impairment of consciousness
Simple partial seizure
no loss of consciousness
General
Involves the entire brain
Tonic clonic seizures (Grand mal)
most common type of seizure
alternating contraction and relaxation of muscles
lasting 1-2 minutes
formerly known as grand mal
loss of consciousness
afterwards patient is confused, drowsy, and sleepy
Tongue biting
Absence seizures (Petit mal)
Brief loss of conscience
Little or no movement
Patient is sometimes unaware of the seizure
Begin in childhood and disappear in middle age
Look for advers effect of long term use of medication
Lasting less than 20 seconds
Status epilepticus
Seizures are continuous
Last longer than 30 minutes
Emergency situation
Dental Hygiene Implications
Review the medical history
Determine cause
Determine age of onset
Determine type of seizure
Review medications used
Determine adherance to taking medication
Determine date of last epileptic episode
Consider time of day of appt and environment (low lights, quiet room)
Medications are likely to cause xerostomia, higher caries risk
Investigate drug-drug Interactions
Make sure patient Is In a safe and comfortable supine position
First Generation
Treatments
Carbamazepine
Oxcarbazepine
Phenobarbital (luminal)
tonig-clonic seizures, partial seizures
Ethosuximide
petit mal seizures
Valproic Acid
first line therapy, complex and simple partial seizures
Benzodiazepines
only for status epilepticus
Phenytoin (dilantin)
Second Generation
Treatments
(newer, more specific sites of action)
(fewer adverse effects)
Levetiracetam
Tigabine - partial mixed, refractory
lamotrigine - partial seizures, refractory partial
Gabapentin - partial seizures
pregabalin- partial seizures
Felbamate
Topiramate - partial/tonic
Zonisamide - partial seizures
Other indications for antiepileptic drugs
Anxiety disorders
Bipolar disorder
Migraine
Neuropathic pain