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Concerns

Seizure

Causes

Signs and symptoms

Action

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.

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

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

Action

Symptoms 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
  • activate emergency medical services (EMS), if no amelioration of seizure activity
  • 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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