Neurologic Disorders

Neurologic Disorder

Seiznre  dis{orders. Patients with a history of seizures should be questioned about the frequency type, duriition, and sequelae of seizures. Seizures can be the result of ethanol withdrawal, high fever, hypoglycemia, or traumatic brain damage, or they can be idiopathic. The dentist should inquire about medications used to control the seizure disorder, particularly about patient compliance . and any recent measurement of serum levels. The patient’s physlcian should be consulted concerning the seizure history and to establish whether oral surgery should be deferred for any reason. If the seizure  isorder is well controlled, standard oral surgical care can be  elivered without any further precautions (except for the use. of an anxiety-reduction protocol) (Box 1-24). If good control cannot be obtained, the patient should be referred to an 01:11 and maxillofacial surgeon for treatment under deep section in the office or hospital.

Edthmolism (Ekohalism). Patients volunteering a history of ethanol abuse or in whom ethanolism is suspected and then confirmed through means other than history taking require special consideration before surgery. The primary problems ethanol abusers have in relation to dental care arc hepatic Insufficiency, ethanol and medication interaction, and withdrawal phenomena. IIep.ltic insufficiency has already been discussed (see page IS). Ethanol interacts with many of the sedatives used for anxiety control during oral surgery. The interaction usually potentate sedation and suppresses the gag reflex. Finally, ethanol abusers may under go with drawal phenomenon hipatic,(.’ period if t+n-y tiave nrutely lowered their daily ethanol Intake before seeking dental care. This phenomenon may exhibit mild agitation, tremors, seizure, diaphoresis, or, more rarely, delirium

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