ORAL AND MAXILLOFACIAL TRAUMA IN PATIENTS WITH EPILEPSY: A PROSPECTIVE STUDY
Main Article Content
Keywords
epilepsy, oral trauma, maxillofacial trauma.
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 OPD and the Emergency department of Hospital during 2025. 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 c2 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.
References
2. Pedley T, Bazil CW, Monell MJ. Epilepsia. In: Rowland LP (Ed). Merritt: tratado de neurologia. 10ª ed, Rio de Janeiro: Guanabara Koogan, 2000;140: 705-723.
3. Commission on Classification and Terminology of the International League against Epilepsy (1981): proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 1981;22:489-501.
4. Sanders J, Weddell JA. Managing patients who have seizure disorders: dental and medical issues. JADA 1995;126:1641-1647.
5. Nakken KO, Lossius R. Seizures-related injuries in multihandcapped patients with therapy-resistant epilepsy. Epilepsy 1993;34:836-840.
6. Aragon CE, Burneo JG, Helman J. Occult maxillofacial trauma in epilepsy. J Contemp Dent Pract 2001;2:26-32.
7. Ogumbodede EO, Adamolekum B, Akintomide AO. Oral health and dental treatment needs in nigerians patients with epilepsy. Epilepsia 1998;39: 590-594.
8. Martim BS. Traumatic intrusion of maxillary permanent incisors into the nasal cavity associated with a seizure disorder: reporter of a case. Dental Traumatol 2003;19:286-288.
9. Oguni H, Fukuyama Y, Imaizumi Y, Ueda T. A video-EEG analisis of drop seizure in myoconic astatic epilepsy of early chishood (Doose syndrome). Epilepsia 1992;33:805-813.
10. Geier S, Bancaud J, Talairach J, et al. The seizures of frontal lobe epilepsy: a study of clinical manifestations. Neurology 1977;27:951-958.
11. Tiamkao S, Sawanyawisuth K, Asawavichienjinda T, et al. Predictive risk factors of seizure-related injury in persons with epilepsy. J Neurol Sci 2009; 15;285:59-61.
12. Andreasen JO, Andreasen FM, Bakland LK, Flores MT. Classificação das lesões traumáticas dentais. In: Andreasen JO, Andreasen FM (Eds). Manual do Traumatismo dental. 9ª ed. Porto Alegre: Artes Médicas, 2000;3:14-15.
13. Silveira ME. Fratura dentoalveolar. In: Barros JJ, Souza L C M (Eds). Traumatismo buco-maxilo-facial. 2ª ed. São Paulo: Roca, 2000;10:265-298.
14. Álvares S, Álvares G. Classificação dos traumatismos dentários: principais danos produzidos. In: Álvares S (Ed). Tratamento do Traumatismo Dentário e Suas Seqüelas. 1ª ed. São Paulo: Artes Médicas (EAP-APCD), 1993;3:23-26.
15. Araújo MAM, Valera MC. Etiologia e classificação dos traumatismos dentários. In: Araújo MAM, Valera MC (Eds). 1ª ed. São Paulo: Artes Médicas (EAP-APCD), 1999;19:1-12.
16. Mello LL, Muller PR. Lesões traumáticas alvéolo- dentárias : fundamentos. In: Mello LL (Ed). Traumatismo alveolodentário. 2ª ed. São Paulo: Artes Médicas (EAP-APCD), 1998;9:1-8.
17. Dingman RO, Nativig P. Princípios gerais. In: Dingman RO (Ed). Cirurgia das fraturas faciais. 1ª ed. São Paulo: Santos, 1995:43-96.
18. Barber HD, Woodbury SC, Silverstain KE, Fonseca RJ. Mandubular fractures. In: Fonseca RJ, Walker RV (Eds). Oral and maxillofacial trauma. 2ª ed. Philadelphia: Saunders, 1997;17:473-522.
19. Perrott DH, Hban LB. Management zigomátic complex fractures. In: Peterson LJ, Indresano AT, Marciani RD, Roser SM (Eds). Oral and maxillofacial surgery. 2ª ed. Philadelphia: Linppincott-Raven, 1997;21:489-508.
20. Zide M. Nasal and naso-orbital- ethmoid fractures. In: Peterson LJ, Indresano AT, Marciani RD, Roser SM (Eds). Oral and maxillofaxial surgery. 2ª ed. Philadelphia: Linppicott- Raven, 1997;23:547-574.