Types of Seizures Chapter 8- DH111
I. Partial Seizures
A. Simple partial- with no loss of consciousness
1. Jacksonian- progression in location of seizure. “Marching”
 Symptoms- stiffening, jerking, tingling
 May progress to generalized tonic-clonic seizure
2. Sensory- causing sensory distortions with out loss of consciousness
 Symptoms- illusions, flashing lights, hallucinations, foul smells
 Auras- can be a sign of impending complex or generalized
seizures
B. Complex partial seizures
1. Impairment of consciousness
2. Also called temporal lobe seizures or psychomotor seizures
3. Begins in temporal lobe, but may progress to entire brain or
Generalized
4. Signs and Symptoms:
 Losing contact with surroundings
 Automatisms- repetitive, non-purposeful activity
 Mental confusion, fear
II. Generalized Seizures- loss of consciousness, genetic or metabolic causes,
Epilepsy
A. Generalized Tonic-Clonic Seizures (GTCS)- most common, also called
Grand mal Seizures
1. Phases of GTCS
a. Aura- simple partial seizure. Patient may hear noise, see
floating, flashing lights, unpleasant smells. Last a few
seconds. Most do not remember.
b. Pre-Ictal- patient loses consciousness, may fall causing
injuries.
c. Ictal- 4 phrases
1. Tonic- patient stiff, rigid. Loud cry, difficulty breathing,
Cyanosis, last 10-20 seconds
2. Hypertonic- extreme muscle rigidity, hyperextension
Of the spine
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3. Clonic-rhythmic, jerky movements, heavy breathing,
Clenched jaw, froth at mouth, last 2-5 minutes
4. Post-Ictal- movement stopped, remains unconscious,
CNS, CVS, respiratory system depression, can lead
To airway obstruction, muscle relaxation, patient
Wakes confused, last minutes to hours
B. Generalized Absence Seizures- or petit mal seizures
 Most common in children
 Genetic
 Blank stare
 Minor facial movements
 Last 5-30 seconds
 May occur 100 times a day
 Can progress to GTCS
 Rare after age 20
 Not always responsive to medications
C. Atonic or Akinetic Seizures
 Drop attack
 Loss of postural tone
 Temporary loss of consciousness
 Primarily in children
D. Myoclonic Seizures
 Bilateral massive epileptic myoclonus
 Brief, bilateral, involuntary muscular jerks-rhythmic
 Usually confined to face, trunk, or one extremity
 Occurs in children <5 years old
 Brief loss of consciousness
E. Febrile Seizures
 Not usually true seizures
 Causes parental concern
 2% cases develop into true seizure disorders
 Associated with fever without intracranial infection
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Treatment of seizures in Dental Office
1. Stop treatment
2. Remove instruments from patient’s mouth
3. Move equipment out of the way
4. Loosen patient’s tight clothing
5. Place in supine position
6. Place one person at foot and one at head of dental chair
7. Call EMS
8. Administer oxygen 4-6 L/min
9. CPR
10. Monitor vitals
11. Gently restrain patient to help avoid injury
12. Do NOT put anything in patient’s mouth
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