Management of an Epileptic Patient with Intellectual Disability: A Case Report and Clinical Guidelines

Comprehensive Management Of Epileptic Patient With Mental Impairment

Authors

  • Ruchi D. Raval
  • K. Mahalinga Bhat
  • G. Subraya Bhat

Keywords:

Intellectual Disability, Epileptic patient, Psychological Dental Therapy, Comprehensive Dental treatment

Abstract

Background: People with epilepsy have compromised livelihood due to the effect of disease and medications on the quality of life. Patients with accompanied intellectual disability have further difficulty to cope up in daily chores. Article highlights holistic management of patient having complex partial seizure with intellectual disability. Control of seizures along with the Psychological therapy was done to ameliorate standard of life. Management of patient consisted of history, oral prophylaxis, patient-parent counselling followed by non pharmacological treatment consisting of cognitive behaviour therapy, promotive autonomy therapy and promotive creativity therapy. She was coached in special school for physiotherapy, speech therapy, music therapy, yoga therapy and special education techniques. Team work between dentist, teachers and psychotherapists gave better accordance with each subsequent appointment. Apart from just teeth oriented approach one should focus on overall care. Timely referral to physician should be done for physical and mental ailments. The article also gives brief clinical guidelines on dental problems and there treatment in such patients along with seizure control of epileptic patients and behaviour management of patients with mental impairment. [Raval R NJIRM 2015; 6(5):108-111]

References

1. Stoopler ET, Sollecito TP and Greenberg MS. Seizure disorders: update of medical and dental considerations. Gen Dent 2003;51(4):361–366.
2. Wyllie E. The treatment of epilepsy principles and practice. 2nd edition. Baltimore (MD): Williams &Wilkins; 1997.
3. Sirven JI. Classifying seizures and epilepsy: a synopsis. Semin Neurol 2002;22(3):237–246.
4. Károlyházy K, Kovács E, Kivovics P, Fejérdy P, Arányi Z. Dental status and oral health of patients with epilepsy: an epidemiologic study. Epilepsia 2003;44(8):1103-1108.
5. Vuilleumier P and Jallon P. Epilepsy and psychiatric disorders: epidemiological data. Review. French. Rev Neurol 1998;154(4):305-317.6. Scheinfeld N. Phenytoin in cutaneous medicine: its uses, mechanisms and side effects. Dermatol Online J 2003;9(3):6.
7. Asconapé JJ. Some common issues in the use of antiepileptic drugs. Review. Semin Neurol 2002;22(1):27-239.
8. Casetta I, Granieri E, Desiderá M et al. Phenytoin induced gingival overgrowth: a community-based cross-sectional study in Ferrara, Italy. Neuroepidemiology1997;16(6):296-303.
9. Karolyhazy K, Kivovics P, Fejerdy P, Aranyi Z. Prosthodontic status and recommended care of patients with epilepsy. J Prosthet Dent 2005;93(2):177–182.
10. Buck D, Baker GA, Jacoby A, Smith D, Chadwick DW. Patients’ experiences of injury as a result of epilepsy. Epilepsia 1997;38(4):439–444.
11. Aragon CE, Burneo JG and Helman J. Occult maxillofacial trauma in epilepsy. J Contemp Dent Pract 2001;2(4):26–32.
12. DeBiase CB. The disabled. In: Dental health education: theory and practice. Philadelphia: Lea & Febiger; 1991.
13. Stiefel DJ and Stull DE. Consideration in care of the patient with a disability. In: Ingersoll BD, ed. Behavioral aspects in dentistry. Norwalk, CT: Appleton-Century-Crofts; 1982.
14. Aragon CE and Burneo JG. Understanding the patient with epilepsy and seizures in the dental practice. Review. J Can Dent Assoc 2007;73(1):71-76.
15. Scott RC, Besag FM and Neville BG. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomized trial. Lancet 1999;353(9153):623-626.
16. Scott RC. Buccal midazolam as rescue therapy for seizures. Lancet Neurol. 2005;4(10):592–593.

Downloads

Published

2018-01-14

How to Cite

Raval, R. D., Bhat, K. M., & Bhat, G. S. (2018). Management of an Epileptic Patient with Intellectual Disability: A Case Report and Clinical Guidelines: Comprehensive Management Of Epileptic Patient With Mental Impairment. National Journal of Integrated Research in Medicine, 6(5), 108–111. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/978

Issue

Section

Case Report