Fall 2015 Medical Emergency Exercise DS3: Coleman Bright

DS4: Jonathan Yih

Medical Emergencies Petit Mal/Absence Seizure

Petit mal (or absence) seizures are fairly common incidences of brief lapses in
consciousness. They are characterized by 10-15 seconds of unresponsiveness and are more
commonly exhibited by children. One of the best ways of caring for a patient with petit
mal/absence seizures is to prepare yourself by thoroughly examining the patients condition and
history.

Medical History of a Patient with Petit Mal/Absence Seizures

Questions to ask when taking the health history:

- How frequent are your seizures?
- How long do they usually last?
- Does anything precipitate your seizures?
- How aware are you after a seizure has passed?
- What medications do you take to help?

Questions for each appointment:

- Have you had any changes to your seizure behavior?
- When was your last absence seizure?
- How frequent have your seizures been recently?

Initially, there may be no need to consult with the patients physician regarding absence
seizures. However, consult with a physician if its the patient is new to seizures or if there is a
strange change. Also, it may be beneficial to send the patient to their physician if the patients
anti-seizure medication is ineffective.

Common Medications for treating Petit Mal/Absence Seizures:

Ethosuximide (Zarontin)
Valproic acid (Depakote)
Lamotrigine (Lamictal)

Treatment Modifiers

Precautions / Preventive Measures

Reduce anxiety and stress for the patient emotional stress and hyperventilation can trigger petit
mal seizures and should be avoided
Otherwise, there are no set precipitating factors for petit mal/absence seizures.

Benzodiazepines can be very useful because they increase the stress threshold and reduce the
chance of a stress-induced seizure, but this usually pertains to the grand mal or epileptic seizure
patient. Also, some medications, especially for generalized tonic-clonic seizures, can cause side
effects that negatively impact oral health.
Fall 2015 Medical Emergency Exercise DS3: Coleman Bright
DS4: Jonathan Yih
Other Issues
One of the main concerns for people exhibiting absence seizures is that they may progress to
generalized tonic-clonic seizures. Some children suffering from absence seizures can also have
difficulties learning, behavior problems, or social isolation.

Recognizing the Petit Mal/Absence Seizure

Signs and Symptoms

- Vacant stare, usually 10-15 seconds without confusion/headache/drowsiness
- Unresponsive
- Sudden stop in motion
- Lip smacking
- Fluttering eyelid or rapid blinking
- Chewing motion
- Rubbing fingers
- Small movements of hands

Absence seizures usually follow with an immediate full recovery and no memory loss.

Emergency Procedure
If a dental patient undergoes an absence seizure during treatment, the following steps should be
taken:

1. Terminate dental treatment

2. Position supine with feet elevated
3. Leave patient alone

If the seizure terminates If the seizure lasts more than 5 minutes

4a. Reassure the patient that they are okay 4b. Activate EMS
5a. Allow for full recovery 5b. BLS as needed
6a. Discharge patient for the day 6b. Aid in transport to definitive care

Sources

Mayo Clinic Staff. "Diseases and Conditions - Absence Seizure." Mayo Clinic. N.p., 3 June 2014.
Web.

Mehmet, Yaltirik, et al. "Management of Epileptic Patients in Dentistry." Surgical Science 3

(2012): 47-52. Jan. 2012. Web.

Schwartz, Steven. "DentalCare." Management of Pediatric Medical Emergencies in the Dental

Office. N.p., n.d. Web. 07 Nov. 2015.