Association between epilepsy and oral maxillofacial trauma: A systematic review and meta-analysis
Saulo Gabriel Moreira Falci DDS, MSc, PhD
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Search for more papers by this authorCorresponding Author
Lucas Duarte-Rodrigues DDS, MSc
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Correspondence
Lucas Duarte-Rodrigues, Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, 187, Diamantina/MG, Brazil. Zip code: 39100-000.
Email: [email protected]
Search for more papers by this authorEdnele Fabyene Primo-Miranda DDS, MSc
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Search for more papers by this authorPatrícia Furtado Gonçalves DDS, MSc, PhD
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Search for more papers by this authorEndi Lanza Galvão MSc, PhD
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Search for more papers by this authorSaulo Gabriel Moreira Falci DDS, MSc, PhD
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Search for more papers by this authorCorresponding Author
Lucas Duarte-Rodrigues DDS, MSc
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Correspondence
Lucas Duarte-Rodrigues, Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Rua da Glória, 187, Diamantina/MG, Brazil. Zip code: 39100-000.
Email: [email protected]
Search for more papers by this authorEdnele Fabyene Primo-Miranda DDS, MSc
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Search for more papers by this authorPatrícia Furtado Gonçalves DDS, MSc, PhD
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Search for more papers by this authorEndi Lanza Galvão MSc, PhD
Department of Dentistry, Postgraduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil
Search for more papers by this authorAbstract
A systematic literature search was conducted (through April 2017), using Web of Science, PubMed and Virtual Health Library, manual reference list, and grey literature searches. The quality of the studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale. The meta-analysis was performed using R software. A total of 30 studies was included in this review. From a total of 25 studies included in the meta-analysis, the prevalence of oral and maxillofacial injuries among epileptic subjects was 19%. Among the epileptic patients who suffered some type of injury due to epileptic seizures, 52% had facial soft tissue injuries (95%CI: 28-75%), 18% suffered dental trauma (95%CI: 11-29%), and 12% (95%CI: 4-28%) suffered maxillofacial fractures. Epileptic patients were more likely to have oral and maxillofacial injuries than healthy individuals (OR: 5.22, 95%CI: 2.84-9.36) and subjects with psychogenic nonepileptic seizures (OR: 2.77, 95%CI: 1.28-5.99), but not than patients with special needs (OR: 2.45,95%CI: 0.95-6.31).
CONFLICT OF INTEREST
The authors whose names are listed immediately below certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
REFERENCES
- 1Adewole RA, Ojini FI, Akinwande JA, Danesi MA. Oro-dental and maxillofacial trauma in epilepsy at a tertiary hospital in Lagos. West Afr J Med. 2011; 30: 114-117.
- 2Karasu HA, Uyanik LO, Koçyiğit ID. Displacement of avulsed tooth into soft tissue of chin resulting from epileptic attack trauma. N Y State Dent J. 2005; 71: 26-28.
- 3Nakken KO, Lossius R. Seizure-related injuries in multihandicapped patients with therapy-resistant epilepsy. Epilepsia. 1993; 34: 836-840.
- 4Buck D, Baker GA, Jacoby A, Smith DF, Chadwick DW. Patients’ experiences of injury as a result of epilepsy. Epilepsia. 1997; 38: 439-444.
- 5Aragon CE, Burneo JG, Helman J. Occult maxillofacial trauma in epilepsy. J Contemp Dent Pract. 2001; 15: 26-32.
- 6Costa ALF, Yasuda CL, França MC, Morita ME, Cendes F. Refractory epilepsy is highly associated with severe dentoalveolar and maxillofacial injuries. Epileptic Disord Int Epilepsy J Videotape. 2011; 13(1): 61-64.
- 7Beghi E. Accidents and injuries in patients with epilepsy. Expert Rev Neurother. 2009; 9(2): 291-298.
- 8Spitz MC, Towbin JA, Shantz D, Adler LE. Risk factors for burns as a consequence of seizures in persons with epilepsy. Epilepsia. 1994; 35(4): 764-767.
- 9Asadi-Pooya AA, Nikseresht A, Yaghoubi E, Nei M. Physical injuries in patients with epilepsy and their associated risk factors. Seizure. 2012; 21(3): 165-168.
- 10Baca CB, Vickrey BG, Vassar SD, Cook A, Berg AT. Injuries in adolescents with childhood-onset epilepsy compared with sibling controls. J Pediatr. 2013; 163(6): 1684-1691.e4.
- 11Deekollu D, Besag FMC, Aylett SE. Seizure-related injuries in a group of young people with epilepsy wearing protective helmets: incidence, types and circumstances. Seizure. 2005; 14(5): 347-353.
- 12Gerreth K, Gerreth P. Occurrence of oral trauma in young epileptic patients. Eur J Paediatr Dent. 2014; 15(1): 13-16.
- 13van den Broek M, Beghi E, RESt-1 Group. Accidents in patients with epilepsy: types, circumstances, and complications: a European cohort study. Epilepsia. 2004; 45(6): 667-672.
- 14Beghi E, Cornaggia C, RESt-1 Group. Morbidity and accidents in patients with epilepsy: results of a European cohort study. Epilepsia. 2002; 43(9): 1076-1083.
- 15Nonato ER, Borges MA. Oral and maxillofacial trauma in patients with epilepsy: prospective study based on an outpatient population. Arq Neuropsiquiatr. 2011; 69(3): 491-495.
- 16Neufeld MY, Vishne T, Chistik V, Korczyn AD. Life-long history of injuries related to seizures. Epilepsy Res. 1999; 34(2-3): 123-127.
- 17Lawn ND, Bamlet WR, Radhakrishnan K, O'Brien PC, So EL. Injuries due to seizures in persons with epilepsy: a population-based study. Neurology. 2004;9; 63(9): 1565-1570.
- 18Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;21; 6(7): e1000097.
- 19Wells G, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. [Internet]. [cited 2018 May 29]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
- 20Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994; 50(4): 1088-1101.
- 21Bifftu BB, Tadesse Tiruneh B, Mekonnen Kelkay M, et al. Seizure-related injuries among people with epilepsy at the outpatient department of the University of Gondar Hospital, Northwest Ethiopia: cross-sectional institutional-based study. Neurol Res Int. 2017; 4970691.
- 22Gawlak D, Łuniewska J, Stojak W, et al. The prevalence of orodental trauma during epileptic seizures in terms of dental treatment—survey study. Neurol Neurochir Pol. 2017; 51(5): 361-365.
- 23Lagunju IA, Oyinlade AO, Babatunde OD. Seizure-related injuries in children and adolescents with epilepsy. Epilepsy Behav EB. 2016; 54: 131-134.
- 24Camfield C, Camfield P. Injuries from seizures are a serious, persistent problem in childhood onset epilepsy: a population-based study. Seizure. 2015; 27: 80-83.
- 25Ghafoor PAF, Rafeeq M, Dubey A. Assessment of oral side effects of Antiepileptic drugs and traumatic oro-facial injuries encountered in Epileptic children. J Int Oral Health JIOH. 2014; 6(2): 126-128.
- 26Bellon M, Walker C, Peterson C. Seizure-related injuries and hospitalizations: self-report data from the 2010 Australian Epilepsy Longitudinal Survey. Epilepsy Behav EB. 2013; 26(1): 7-10.
- 27Mollaoğlu M, Bolayir E. Injuries in patients with epilepsy and some factors associated with injury. Noro Psikiyatri Arsivi. 2013; 50(3): 269-273.
- 28Atkinson M, Shah A, Hari K, Schaefer K, Bhattacharya P, Shah A. Safety considerations in the epilepsy monitoring unit for psychogenic nonepileptic seizures. Epilepsy Behav EB. 2012; 25(2): 176-180.
- 29Gurbuz T, Tan H. Oral health status in epileptic children. Pediatr Int Off J Jpn Pediatr Soc. 2010; 52(2): 279-283.
- 30Friedman DE, Gilliam FG. Seizure-related injuries are underreported in pharmacoresistant localization-related epilepsy. Epilepsia. 2010; 51(1): 43-47.
- 31Lees A. Retrospective study of seizure-related injuries in older people: a 10-year observation. Epilepsy Behav EB. 2010; 19(3): 441-444.
- 32Ting YW, Kwong KL. Seizure-related injuries in newly diagnosed childhood epilepsy. Pediatr Neurol. 2010; 42(6): 417-421.
- 33Percival T, Aylett SE, Pool F, Bloch-Zupan A, Roberts GJ, Lucas VS. Oral health of children with intractable epilepsy attending the UK National Centre for Young People with Epilepsy. Eur Arch Paediatr Dent Off J Eur Acad Paediatr Dent. 2009; 10(1): 19-24.
- 34Thomas RH, Higgins S, Fuller GN. Dental injury during seizures associated with juvenile myoclonic epilepsy. J Neurol Neurosurg Psychiatry. 2009; 80(1): 91-93.
- 35Buffo TH, Guerreiro MM, Tai P, Montenegro MA. Seizure related accidents and injuries in childhood. Arq Neuropsiquiatr. 2008; 66(3A): 458-461.
- 36Oliva M, Pattison C, Carino J, Roten A, Matkovic Z, O'Brien TJ. The diagnostic value of oral lacerations and incontinence during convulsive “seizures.” Epilepsia. 2008; 49(6): 962-967.
- 37Sapna CS, Sheeba SL, John J, Thomas SV. Accidents and injuries in people with epilepsy attending a tertiary care center in India. Epileptic Disord Int Epilepsy J Videotape. 2008; 10(4): 276-281.
- 38Tiamkao S, Shorvon SD. Seizure-related injury in an adult tertiary epilepsy clinic. Hong Kong Med J Xianggang Yi Xue Za Zhi. 2006; 12(4): 260-263.
- 39Tiamkao S, Amornsin O, Pongchaiyakul C, et al. Seizure-related injuries in northeast Thailand. J Med Assoc Thail Chotmaihet Thangphaet. 2006; 89(5): 608-613.
- 40Ogunbodede EO, Adamolekun B, Akintomide AO. Oral health and dental treatment needs in Nigerian patients with epilepsy. Epilepsia. 1998; 39(6): 590-594.
- 41Peguero E, Abou-Khalil B, Fakhoury T, Mathews G. Self-injury and incontinence in psychogenic seizures. Epilepsia. 1995; 36(6): 586-591.
- 42Sureka R, Paliwal J, Mohd T, Sureka RK. Oral health of epileptic patients in rural Rajasthan. J Evol Med Dent Sci. 2015; 24(88): 15367-15369.
- 43Ferreira MCD, Guare RO, Prokopowitsch I, Santos MTBR. Prevalence of dental trauma in individuals with special needs. Dent Traumatol Off Publ Int Assoc Dent Traumatol. 2011; 27(2): 113-116.
10.1111/j.1600-9657.2010.00961.x Google Scholar
- 44Fawale MB, Owolabi MO, Ogunniyi A. Effects of seizure severity and seizure freedom on the health-related quality of life of an African population of people with epilepsy. Epilepsy Behav EB. 2014; 32: 9-14.
- 45Wirrell EC. Epilepsy-related injuries. Epilepsia. 2006; 47(Suppl 1): 79-86.
- 46Haasum Y, Johnell K. Use of antiepileptic drugs and risk of falls in old age: a systematic review. Epilepsy Res. 2017; 138: 98-104.
- 47Asadi-Pooya AA, Sperling MR. Antiepileptic Drugs: A Clinician's Manual. New York, NY: Oxford University Press. 2015; 299 p.
- 48Carvalho Filho MAM, Saintrain MV, de L, et al. Prevalence of oral and maxillofacial trauma in elders admitted to a reference hospital in Northeastern Brazil. PloS One. 2015; 10(8): e0135813.
- 49Kovacs M, Pacurar M, Petcu B, Bukhari C. Prevalence of traumatic dental injuries in children who attended two dental clinics in Targu Mures between 2003 and 2011. Oral Health Dent Manag. 2012; 11(3): 116-124.
- 50Hingray C, Biberon J, El-Hage W, de Toffol B. Psychogenic non-epileptic seizures (PNES). Rev Neurol (Paris). 2016; 172(4-5): 263-269.
- 51Brigo F, Storti M, Lochner P, et al. Tongue biting in epileptic seizures and psychogenic events: an evidence-based perspective. Epilepsy Behav EB. 2012; 25(2): 251-255.
- 52Tamber MS, Mountz JM. Advances in the diagnosis and treatment of epilepsy. Semin Nucl Med. 2012; 42(6): 371-386.