Epilepsy & Cerebral Palsy

EPILEPSY

a neurological disorder that affects the brain and causes recurrent,

unprovoked seizures due to abnormal electrical signals produced by damaged brain cells

SEIZURE DISORDER

Epilepsy is also called a

Seizures

A burst of uncontrolled electrical activity within brain cells causes a

changes ti your awareness

muscle control (your muscles may twitch or jerk)

sensations

emotions

behavior

Seizures can include changes to

Some people may lose awareness during a seizure while others don't. Some people stare blankly for a few seconds during a seizure.

Seizure symptoms can vary widely in a way?

• Seizures

• Uncontrolled movements

• Altered consciousness

• Sensory disturbances

• Emotional or behavioral changes

Give me CHARACTERISTICS OF EPILEPSY

stress, sleep deprivation, or flashing lights

What triggers epilepsy

SEIZURES

Can vary from brief lapses in awareness (absence seizures) to convulsions with

loss of consciousness (tonic-clonic seizures)

• Caused by abnormal electrical activity in the brain

Uncontrolled movements

-

Jerking, twitching, or stiffening of muscles

Uncontrolled movements

Caused by excessive or misfiring nerve signals affecting motor control.

Altered consciousness

Confusion, staring spells, or unresponsiveness

Altered consciousness

Due to disrupted communication between brain regions

Sensory disturbances

Strange sensations, visual distortions, or unusual smells/tastes.

-Result from seizure activity in sensory-processing brain areas

Emotional or behavioral changes

• Anxiety, déjà vu, or sudden mood shifts before or after a seizure

• Due to seizures affecting the brain’s emotional regulation centers

• prioritize patient safety by scheduling appointments during times when seizures are less likely,

• minimizing stress triggers,

• explaining procedures thoroughly

Management of Epilepsy (1)

• ensuring medication is taken as prescribed,

• and being prepared to respond calmly if a seizure occurs by removing instruments,

• positioning the patient safely

• monitoring their airway;

• never restrain the patient or put anything in their mouth during a seizure

Management of Epilepsy (2)

Communication is key

●Ask the patient about their seizure history, triggers, medication regimen, and any

concerns they may have about dental treatment.

●Schedule strategically

●Medication check

●Environment management

Pre-appointment preparation

●Stay calm and attentive

● Explain procedures clearly

●Use local anesthetic cautiously

●Instrument management

During treatment

Consider using a lower dose of local anesthetic if necessary

Use local anesthetic cautiously

●Position the patient safely: If a seizure occurs, lower the dental chair and gently position the patient on their side to prevent aspiration.

●Clear the area: Remove any sharp objects or instruments from around the patient.

●Do not restrain: Never try to restrain the patient during a seizure.

Managing a seizure (1)

●Monitor airway: Keep an eye on the patient's breathing and be prepared to administer oxygen if needed.

●Time the seizure: Note the duration of the seizure and contact emergency services if it

lasts longer than 5 minutes or if there are complications

Managing a seizure (2)

1. Gingival Hyperplasia

2. Increased Risk of Dental Trauma

3. Xerostomia

4. Increased Risk of Cavities and Gum Diseases

5. Oral Candidiasis

6. Bruxism

7. Drug-Induced Oral Side Effects

ORAL CONDITIONS OF PATIENTS WITH EPILEPSY

Gingival Hyperplasia

-it is the overgrowth of gums usually caused by anti-seizure medications

particularly Phenytoin (Dilantin Sodium)

falls,

jaw injuries,

broken or knock-out teeth,

lip and tongue biting,

and fractures of the jaw bone

Seizures often leads to

Biting of the cheeks and tongue

very common during epileptic seizures, especially during tonic-clonic seizures

Most anti-epileptic drugs (AEDs)

Under Xerostomia

What causes to reduce saliva production leading to dry mouth

thus increasing the risk of tooth decay, gum disease, bad breath, and oral infections

Oral Candidiasis

a.k.a Oral Thrush

Oral Candidiasis

-it is a fungal infection of the mouth characterized by raised creamy white patches on the tongue or inner cheeks

ulcers, gum bleeding

problems, taste changes, or allergic reactions affecting the mouth

Under Drug-Induced Oral Side Effects

-Most patients with maintenance of anti-epileptic drugs (AEDs) often have

CEREBRAL PALSY

is a group of permanent neurological disorders that affects body

movement, balance, posture and muscle control

CEREBRAL PALSY

It most often occurs before birth,

caused by damage that occurs to the developing brain

CEREBRAL PALSY

may also make it difficult to swallow, affect vision by causing eye muscle

imbalances and muscle stiffness due to reduced joint motions

CEREBRAL PALSY

The condition generally stays the same over time, although there is no cure, there are treatments to help improve the affected persons function in their day to day lives

Spastic

Dyskinetic

Mixed

3 Types of Cerebral Epilepsy

Spastic

involves muscle tightness and spasms

Dyskinetic

involves issues with muscle control

Mixed

involves features of both the spastic and dyskinetic types

Diplegic

affects your arms more than your legs

Quadriplegic

affects all your limbs

Hemiplegic

affects one side of your body (left or right) more than the other

Monoplegic

affects one limb

Paraplegic

affects your legs

Head size differences

Irritability

Hypotonia

Delayed development

Under Cerebral Palsy

Give Some examples of non-movement signs and symptoms include:

unusually small head (microcephaly) or an

unusually large head (macrocephaly)

Head size differences

Irritability

Lack of interaction: Babies and children with CP may not react to people around them

Hypotonia

This means a lack of muscle tone, giving affected body parts a “floppy” appearance

(this usually happens early on and later becomes spasticity or dystonia)

Cerebral palsy isn’t curable, but the symptoms and effects are treatable

How is cerebral palsy curable?

Physical therapy

most important treatments for cerebral palsy (physiotheraphy)

• Medications

• Surgeries

• Physical therapy

• Speech therapy

• Mental health therapy

• Occupational Therapy

• Social work and educational support

MANAGEMENT

How is cerebral palsy treated

1. Malocclusion (Misaligned Teeth)

2. Bruxism (Teeth Grinding)

3. Drooling (Sialorrhea)

4. Dental Caries (Cavities)

5. Gingival Hyperplasia (Overgrown Gums) (Due to anticonvulsants: phenytoin)

6. Periodontal Disease (Gum Disease)

7. Trauma and Injuries

8. Temporomandibular Joint Disorders (TMJ Issues)

9. Xerostomia (Dry Mouth)

Oral Conditions for people w/ Cerebral Palsy

• Use adaptive toothbrushes or electric toothbrushes for easier cleaning.

• Regular dental check-ups and professional cleanings.

• Fluoride treatments to strengthen enamel.

• Speech and occupational therapy to improve oral muscle function.

• Medication management to reduce side effects affecting oral health

Oral Care Tips for Individuals with CP