Management of the pediatric dental patient with seizure disorder: prevention and treatment of emergencies

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.