Developmental disability and epilepsy Flashcards
Describe epilepsy
- Epilepsy is a disease of the brain characterised by recurrent seizures
- Seizures: disruption of the normal electrochemical activity of the brain.
List the 4 types of seizures
Focal aware seizure
Focal impaired awareness seizure
Absence seizure
Clonic- tonic seizures
List the 5 types of focal aware seizures
Focal motor seizure
Focal sensory seizure
Focal autonomic seizures
Focal cognitive seizures
Focal emotional seizures
Describe focal aware seizures and its subtypes
• Seizure that starts in one area of the brain and the person remains alert and able to interact
Focal motor seizure
• Movements, such as jerking, posturing or stiffening of arm/s or leg/s, twitching of face
Focal sensory seizure
• Sensations, such as numbness, tingling or burning feeling in a part of the body
Focal autonomic seizures
• involuntary body changes, such as blushing, looking pale or grey, increased heart rate, nausea, and perspiring
Focal cognitive seizures
• characterised by impaired language or cognition; hallucinations (visual, smell, taste or hearing)
Focal emotional seizures
• characterised by feeling emotions such as joy, sadness, anxiety, fear or panic.
Describe focal impaired awareness seizures in terms of: • Description • Signs/ symptoms • Duration • Aftermath
Description:
• Person NOT aware of surroundings . Usually, the person does not respond
• If persons does respond, it is usually inappropriate.
Signs and symptoms
• Vacant stare and loss of expression
• Confused face
• Unusual and repetitive behaviour like chewing, fidgeting, walking around or mumbling
Duration
• Lasts from 30 seconds to 3 minutes
Aftermath
• Person is often confused and may not remember anything that happened
Describe absence seizures in terms of : Description Signs and symptoms Duration Aftermath
Description
• The seizure starts suddenly with the person stopping their activity
Signs and symptoms
• Loss of facial expression and unresponsiveness
• Sometimes eye blinking or upward eye movements are seen
Duration
• Lasts from two to 20 seconds and ends abruptly
Aftermath
• Person has no memory of what happened
Describe clonic- tonic seizures in terms of: Description Signs and symptoms Duration Aftermath
Description
• A sudden loss of consciousness, sometimes with vocalisation or calling out
• If standing, the person will fall
• Person will not respond when spoken to
Signs and symptoms
• The eyes, head and body may turn in one direction
• The body becomes stiff (tonic), followed by jerking of the muscles (clonic)
• Breathing may be shallow or briefly stopped which may cause the lips and face to look greyish/blue
• Excess saliva may come of the person’s mouth
• May bite tongue or cheek
• Possible loss of bladder or bowel control
Duration
• 2 minutes or less
Aftermath
• After the seizure, the person is often confused and may not remember anything that happened
Understand the non-dental and dental triggers of epileptic fits
Non- dental • Fatigue • Stress • Alcohol • Medication
Dental
• Dental lights
• Local anaesthetic
• NO2 (happy gas)
Know the oral side effects of epileptic drugs
- Xerostomia
* Gingival enlargement
Know what cerebral palsy is and main causes of it
- Disorder of movement and posture (a descriptive term; NOT a diagnosis)
- Permanent, non-progressive
• CAUSE: Due to defect or lesion in developing brain
Describe the types of cerebral palsy
• Hypotonic
• Spastic
• Dyskinetic
- Hypotonic: diminished muscle tone, appear floppy, can’t hold head up
- Spastic: muscle stiffens, rigidity
- Dyskinetic: inability too control muscle movement
List conditions associated with cerebral palsy
- Epilepsy
- Reflux disease
- Intellectual disability
- Hearing and vision impairments
- Chronic lung disease; aspiration, can’t clear secretions
- Urinary incontinence
- Scoliosis
- Hip shoulder dislocation
- Osteoporosis
Know risk factors for cerebral palsy
- Premature birth with/ or low weight
- Infection in utero
- Developmental brain anomalies
- Hypoxia (perinatal)/ or near drowning
- Cord around neck
- Traumatic head injury
- Meningitis, encephalitis
List the oral manifestations of cerebral palsy
- Malocclusion (abnormal muscle function)
- Periodontal disease
- Caries
- High rates of dental extractions
- Bruxism
- Chewing problems, dysphagia
- Dental erosions from gastro-oesophageal reflux
- Poor saliva control (Sialorrhoea)
Understand the issues with dental management of people with cerebral palsy
- Communication /cognitive difficulties impair ability to obtain history or give instructions
- Oral hygiene impaired
- May resist brushing
- Medication affects saliva
- Scoliosis can make positioning difficult, and severe scoliosis reduces lung capacity
- Weak or absent gag reflex increases risk of aspiration
- Poor seizure control complicates sedation
- May need muscle relaxants, sedation or general anaesthetic
