Management of Pediatric Medical Emergencies in the Dental Office
Seizures

Seizures are temporary alterations in brain function resulting in an abrupt onset of motor, sensory or psychic symptoms. Except when seizures follow one another closely for an extended period of time, they are not considered life threatening. Emergency management of a patient experiencing a seizure is essentially preventing injury during the seizure and supportive therapy post seizure.

There are multiple causes of seizures:

• Congenital abnormalities
• Perinatal injuries
• Metabolic and toxic disorders
• Head trauma
• Tumors
• Vascular diseases
• Degenerative disorders
• Infectious diseases
• Elevated body temperature (febrile seizures)
  • Most commonly occurs between 6 months and 3 years
  • Fever of 38.8° C (102°F)
  • Infection not associated with the CNS
  • Seizures are short (<5 minutes)
  • Are insignificant in the dental setting

While all patients with epilepsy have seizures, many more patients have a single seizure during life and do not have epilepsy. Ten percent of the U.S. population will have at least one seizure in their lifetime, while the incidence of epilepsy is less than 1%.

There are three major forms of seizures:

• Grand mal (tonic-clonic seizure)
• Petit Mal (absence seizure)
• Status epilepticus