E-360 Edition 15: Questions and Answers

Home > E-360 Edition 15: Questions and Answers

Q: I recently went to the dentist and needed cavities filled. The dentist told me that he can’t fill them or do any other treatment because I’ve recently had seizures. Is this something others with epilepsy go through?

A: If anything, people with epilepsy should see a dentist more often. Seizures and some antiepileptic medication can affect dental and oral health such trauma, gum overgrowth and ulcers.

There doesn’t seem to be a consistent practice amongst dentists in regards to if someone has had a recent seizure or not before going to the dentist. It is wise share with your dentist that you have epilepsy. They need to be prepared for possible medical emergencies rather than guess what is going on. Include what type of seizures you have, what can trigger them, and how often or when they are most likely to occur. They should probably know your medication as well so if they need to prescribe you anything, they can avoid bad drug combinations.  Think about what can trigger your seizures – such as stress or bright lights – both of which seem to be in the dental clinic.

Also, tell your dentist if you are taking Epilim because this affects blood clotting, and you bleed for a bit longer. Help to educate your dental provider on the disorder.

With regard to the safety of local anaesthesia to people with epilepsy, it has been reported that the issue is still inconclusive and not certain. Although there have been some reports of seizures after local anaesthesia at the dentist, there is no evidence available concerning the convulsive effects of low-dose anaesthetic during dental treatment.

It may be worth seeking the opinion of another dentist.

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Q: Since starting Lamotrigine I find I have excessive flatulence. Is this common?

A: Gastrointestinal side effects are often reported when taking lamotrigine, and flatulence or wind is sometimes mentioned, particularly in the initial stages of starting the medication. It is not a serious side effect, but if it bothers you then raise it with your neurologist or a dietician to discuss possible dietary modifications to lessen the effect.

Q: I have epilepsy and want to go mountain climbing at Everest Base Camp next year. I’ve heard that altitude can cause seizures. Is this true?

A: Climbing to high altitude can cause acute mountain sickness syndrome that commonly affects otherwise healthy men and women. Neurological impairment related to high altitude is well recognised, but there really is no evidence that seizures are more frequent at high altitudes than at sea level. Also, there are no studies showing a link between altitude related metabolic disturbances (such as hypoxia, over hydration, low blood sugar or sodium) and an increase of true epileptic seizures, nor that people with epilepsy are more susceptible to them than others without epilepsy.

Having said that, the risk for you having a seizure from high altitudes is hard to predict. Everest Base Camp is the most extreme conditions. There are some gymnasiums (in Perth, Melbourne, Canberra and Sydney) that provide high altitude training conditions. It may be worth contacting the health professional linked to this type of facility to arrange a test period to see how you may be affected.

Some medical professionals may advise you not to go, but you may not have a seizure at all. You will need to make a decision based on the professional advice you receive from experienced experts in this area.

It is also possible that some seizures at high altitude may be triggered by other things such as overtiredness, lack of sleep or dehydration.

Sensible precautions can help:

  • if you can, arrive early to acclimatise before climbing.
  • don’t overdo it, drink enough fluids (don’t over-hydrate though) and eat well,
  • don’t climb too fast (that is, don’t climb too higher altitude quickly), take it easy,
  • try to get enough sleep, as sometimes it is hard to sleep in altitude,
  • speak to your specialist about any medications that may help with altitude sickness,
  • and use common sense.

Also make sure someone in your group knows you have epilepsy and what to do in case of a seizure, and have a plan B and plan C if things don’t go as expected.

Safety climbing precautions are paramount not only for you but for everyone in the group.

Q: There is temporal lobe epilepsy in my family and now my 5 year old daughter has started having tics. Does this mean she may have epilepsy?

A: Tics are relatively common and generally do not mean epilepsy. The jerking movements associated with some tics can be mistaken for epilepsy and vice versa – myoclonic or focal motor seizures may be mistaken for tics. However, because tics are so common, they can also co-exist in some people with epilepsy. Having tics does not increase the risk of epilepsy though. I would advise you to take your daughter to a paediatrician or neurologist -for a thorough assessment.