Oral and maxillofacial trauma in patients with epilepsy: prospective study based on an outpatient population

Abstract

Objective: This study aimed to evaluate oral and maxillofacial trauma caused by falls during epileptic seizures. Method: A prospective case-control study was carried out among patients recruited from both the Epileptic Outpatient Clinic and the Emergency Room of Hospital de Base during 2006. The study group was composed of patients with epilepsy that had been diagnosed by a specialist. Oral and maxillofacial trauma was diagnosed using a questionnaire together with physical and radiographic examinations. A control group was formed from non-epileptic relatives or neighbors of the patients. The two groups were compared with regard to the number and type of oral and maxillofacial trauma events suffered. Odds ratios with a 95% confidence interval, dependency analysis and the Pearson c 2 test were used for statistical analysis, and the significance level was set at p≤0.05. Results: A total of 159 patients with epilepsy (91 males; 57.3%) and 68 control individuals (28 males; 41.1%) were enrolled in the study. The frequencies of oromaxillary trauma in the study and control groups were 23.9% and 4.4%, respectively. Generalized tonic-clonic, generalized and non-classified seizures were strongly associated with trauma. The commonest lesions were fractures of dental tooth crowns (32.9%), followed by tooth avulsion (7.6%), tooth luxation (5%) and fracturing of prostheses in edentulous patients (3.8%). Conclusion: This work shows that injuries to the face and teeth are statistically more common in patients with epilepsy than in the general population, and that individuals who suffer seizures without aura are the most affected. Key words: epilepsy, oral trauma, maxillofacial trauma.Trauma oral e maxilofacial em pessoas com epilepsia: estudo prospectivo com base ambulatorial RESUMO Objetivo: O objetivo desse estudo foi avaliar a relação da epilepsia sobre as ocorrências de trauma dento-alveolar e maxilofacial causados por quedas. Método: Estudo casocontrole prospectivo foi conduzido no ambulatório de epilepsia e do Pronto Atendimento do Hospital de Base de São José do Rio Preto-SP no ano de 2006. Pacientes do grupo caso foram diagnosticados pelo neurologista chefe (sênior) especialista em epilepsia e avaliados quanto ao trauma oral e maxilo-facial pelo pesquisador, por meio de questionário, exame clínico e radiográfico, por ordem de chegada. O grupo controle (GC) foi constituído incluindo indivíduos sem crises, que fossem familiares ou vizinhos próximos dos pacientes com diagnóstico de epilepsia. Intervalo de confiança 95%, ODD, análise de dependência (ANADEP) e c 2 de Pearson foram utilizados para análise estatística e se adotou nível de significância de p≤0,05. Resultados: Analisaram-se 159 pacientes com epilepsia, dos quais 91(57,3%) masculinos e 68 do GC, dos quais 28 (41,1%) masculinos. A frequência do trauma oro-maxilar em paciente com epilepsia foi 23,9% e no GC foi de 4,4. As crises tônico-clônicas generalizadas, crises generalizadas e as não classificadas estão fortemente co-relacionadas ao trauma. Fraturas das...

Association between epilepsy and oral maxillofacial trauma: A systematic review and meta‐analysis

“…Considering all included studies, a total of 7277 patients were screened to evaluate the influence of epilepsy on the occurrence of oral and maxillofacial injuries. The full process of study selection is illustrated in Figure .…”

“…Previous investigations have shown that epileptic individuals are prone to suffer more accidents when compared to the healthy subjects ones, among which the seizure‐related ones are considered as the most common injuries . However, some studies which assessed the risk of oral and maxillofacial injuries in epileptic individuals compared to the general population, have revealed controversial results …”

Epileptik Bir Hastada Mentumda Olağandışı Yabancı Cisim

“…A study on 159 epileptic and 68 healthy subjects reported by Nonato and Borges revealed that oromaxillary traumas had significantly higher incidence in the epileptic group 2 5 . Incisions in order to remove skin penetrating and embedded sharp foreign bodies such as needle and glass should be parallel to the foreign body.…”

Management of cervical root fracture injury in a patient with epilepsy: Case report with 5‐year follow‐up

“…Traumatic dental injuries are commonly observed among patients with epileptic seizures . When compared to healthy controls, the relative risk for having injury was found to be 3.42 in patients with epilepsy .…”

“…Traumatic dental injuries are commonly observed among patients with epileptic seizures. 4,5 When compared to healthy © 2018 Special Care Dentistry Association and Wiley Periodicals, Inc. controls, the relative risk for having injury was found to be 3.42 in patients with epilepsy. 4 Lagunju et al 6 have reported a significantly higher frequency of injuries in children with epilepsy compared with their age-and sex-matched counterparts.…”