Shapira Y, Sapir S, Amir E
Dept. of Pediatric Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem.
Refuat Hapeh Vehashinayim (1993). 2003 Sep;20(4):6-10, 86.
Seizures are not infrequent in childhood and may occur during dental treatment. Generalized seizures and particularly the Tonic-clonic (grand-mal) are the most hazardous and may induce self-injury, aspiration, and medical emergency as status epilepticus. The differential diagnosis of isolated seizure attack should consider hyperventilation, hyperglycemia, local anesthetic toxicity, and anoxia. The pediatric dentist should be aware of predisposing factors that may induce seizure attack in their patients. Proper precautionary measures could prevent the attack from occurring or at least reduce its consequences. The diagnosis as to the cause of the seizure, as well as providing proper management, could prevent further complications. This article presents the medical and dental history relevant for prevention of seizure attack in the dental chair, antiepileptic drugs with possible interactions with the dental treatment and management of such attack, should they occurs.
癫痫发作在儿童时期并不罕见,且可能在牙科治疗期间发生。全身性癫痫发作,尤其是强直阵挛性(大发作)发作最为危险,可能导致自我伤害、误吸,并引发癫痫持续状态等医疗紧急情况。孤立性癫痫发作的鉴别诊断应考虑过度通气、高血糖、局部麻醉药毒性和缺氧。儿科牙医应了解可能诱发其患者癫痫发作的易感因素。适当的预防措施可以防止发作的发生,或者至少减轻其后果。对癫痫发作原因的诊断以及进行适当的处理,可以预防进一步的并发症。本文介绍了与预防牙科治疗椅上癫痫发作相关的病史、可能与牙科治疗相互作用的抗癫痫药物以及此类发作发生时的处理方法。