Seizure
Uncontrolled electrical activity in the brain.
Types of seizures
Seizures may range from a simple blank stare to loss of consciousness with spasticity or muscle jerking.
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Signs and symptoms- change in alertness
- unexplainable fear, panic, joy, or laughter
- change in sensation of the skin, usually spreading over the arm, leg, or trunk
- seeing flashing lights (can precede a seizure)
- auditory changes (can precede a seizure)
- hallucinations (rare occurrence)
- sudden loss of muscle control and falling
- muscle twitching that may spread up or down an arm or leg
- muscle tension or tightening that causes twisting of the body, head, arms, or legs
- shaking of the entire body
- tasting a bitter or metallic flavor
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ActionSymptoms may stop after a few minutes or continue for up to 15 minutes or more.
- lower and fully recline the dental chair
- assure patient and staff safety without restraining the patient
- administer oxygen, 6-8 L/min via a nasal canula or a mask
- manage the airway
- do not try to pry the mouth open
- if impending seizure is recognized, safely remove all appliances and other objects from the patient’s mouth
- have suction available
- monitor blood pressure, pulse and respiratory rate
- use a pulse oximetry, when available
- if seizure last >5 minutes, administer IV benzodiazepine when available
- support airway
- if no amelioration of seizure activity, alert emergency medical services (EMS)
- allow the patient to sleep after cessation of seizure activity
- arrange for home escort
- notify patient’s primary care provider
- call later to check on patient
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Causes- epilepsy
- abnormal blood levels of sodium or glucose
- stroke or head injury
- brain tumor
- dementia, such as Alzheimer’s disease
- high fever
- brain infections, including meningitis, encephalitis,or neurosyphilis
- kidney failure
- liver failure
- cocaine or amphetamine use
- alcohol withdrawal
- medication withdrawal from painkillers and sleeping pills
- syncope
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Related Pages- Medical Disorders
- Medical Emergencies
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References/Websites- References
- Greenwood M, et al. General medicine and surgery for dental practitioners: part 2. Medical emergencies in dental practice: the drug box, equipment and basic principles of management. BDJ. 2014;216(11):633-637.
- Greenwood M. General medicine and surgery for dental practitioners: part 3. Management of specific medical emergencies in dental practice. BDJ. 2014;217(1):21-26.
- Haas DA. Preparing dental office staff members for emergencies. Developing a basic action plan JADA. 2010;141(5 suppl):8S-13S.
- Rosenberg M. Preparing for medical emergencies. The essential drugs and equipment for the dental office. JADA. 2010;141(5 suppl):14S-19S.
- Jevon P. Medical emergencies in the dental practice poster: revised and updated. BDJ. 2020;229(2):97-104.