Oro-Dental and Maxillofacial Trauma in Epilepsy at a Tertiary Hospital in Lagos

BACKGROUND: Seizure-related injuries are common and are a major cause of morbidity in subjects with epilepsy. OBJECTIVE: To determine the frequency and types of oro-facial injuries in epileptic patients attending a tertiary hospital. METHODS: A structured questionnaire was used to obtain information about injuries to the oral and maxillofacial region in epileptic patients at the Neurology Clinic of the Lagos University Teaching Hospital over a period of two years. Information sought included patient’s sociodemographics, type of seizure, self-management of seizures, and history of injuries during seizures. RESULTS: Of the 138 epileptic patients seen, 87 (63.0%) reported the occurrence of oral and maxillofacial injuries. Mean age of these patients (29.6±12.1 years) was not significantly different from that of those who had no injuries (33.5±15.6 years). Prevalence of seizure-related injuries was not significantly different in males and females (50 [58.8%] vs 37 [71.2%]). Injuries were more likely in those who had convulsive seizures than in those who had non-convulsive seizures. Patients who had hard objects forced between their clenched teeth during seizure episodes were more likely to sustain injuries. Soft tissue injuries were more common than injuries to the facial bones and teeth. Of these, the tongue was the most commonly injured. Majority of those with soft tissue injuries did not receive treatment in hospital. Although fractures of the cheek and jaw bones were not so common, all such cases received surgical treatment in hospital. CONCLUSION: A high proportion of epileptic patients in Lagos appear to suffer seizure-related oro-facial injuries. Measures for the prevention and management of these injuries are needed to help reduce the morbidity caused by such injuries.