Management of Epilepsy

Question 1

Pt w/ hx of epilepsy attends clinic for a fill. Give second cartridge of lidocaine and pt becomes stiff and limbs start jerking - what is dx?

Answer 1

Epileptic seizure

Question 2

What can trigger epilepsy?

Answer 2

Can be random w/o triggers
Dental setting - stress and anxiety are possible triggers
Lack of sleep, alcohol and drugs can trigger

Question 3

What are the different types of seizure?

Answer 3

Generalised
Focal
Absence

Question 4

What are generalised seizures?

Answer 4

Most common
LOC, tonic contractions followed clonic jerking

Question 5

What is focal seizure?

Answer 5

Arise one portion of brain
Speech impairment, loss of memory, impaired response

Question 6

What is absence seizure?

Answer 6

Behavioural arrest or staring - last 5-10 sec

Question 7

How mx epilepsy?

Answer 7

Remove sharps/ items away from pt
Lower dental chair
Don’t restrain pt
If demonstrate sign of recovery, place in recovery position

Question 8

When calll 999?

Answer 8

Pt condition worsen, seizure reoccurs, pt injured, pt having problems breathing, difficult to rouse
First time pt has seizure
Status epilepticus

Question 9

What medications may be used?

Answer 9

Midazlolam - if seizure lasts > 5 mins, or > 3 seizures in hour
Airway management
Oxygen supply