Tooth Brushing–Induced Seizures: A Case Report

Koutroumanidis, Michael; Pearce, R. K. B.; Sadoh, D; Panayiotopoulos, C. P.

doi:10.1046/j.1528-1157.2001.32700.x

Cited by 24 publications

(22 citation statements)

References 3 publications

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“…Reflex seizures are often readily controlled with medication. This favorable response is to be expected in patients with idiopathic epilepsies, such as primary generalized epilepsies and reflex seizures related to photic stimuli, and also is seen in patients with partial cryptogenic epilepsies (1,3,5,6,8,22–24). Conversely, a few series and single‐case reports of patients with symptomatic partial epilepsies and refractory reflex seizures have been published (9,25–28), and the present series would support the view that reflex seizures in the context of symptomatic epilepsies tend to be medically refractory.…”

Section: Discussionmentioning

confidence: 89%

Reflex Seizures in Patients with Malformations of Cortical Development and Refractory Epilepsy

Palmini

Halász²,

Scheffer

et al. 2005

Epilepsia

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Summary:Purpose: Malformations of cortical development (MCDs) are usually highly epileptogenic, and their hyperexcitability could facilitate the occurrence of reflex seizures. We sought to characterize reflex seizures in patients with MCDs and refractory epilepsy.Methods: Clinical, electrographic, and neuroimaging data were reviewed in eight patients with MCDs who had reflex seizures reproduced during presurgical evaluation.Results: All eight patients had both reflex and spontaneous seizures. In six, however, drop attacks or axial myoclonic seizures occurred only upon specific sensory stimulation. Reflex seizures were induced by more than one type of stimulus in most patients, but anatomofunctional correlations could usually be invoked. Six patients had significant intellectual impairment. Surgical resection controlled seizures in two patients.Conclusions: Reflex seizures in patients with MCDs may be medically refractory and may often manifest as drop attacks or axial myoclonus. Surgical resection of focal lesions can bring reflex seizures under control. Putative mechanisms related to the relatively low frequency of reflex seizures in MCDs are discussed. Key Words: Reflex seizures-Malformations of cortical development-High degrees of epileptogenicity.Reflex seizures most commonly occur in patients with genetically related epilepsy syndromes (1-6), in which triggering stimuli are related to photosensitivity or higherorder cognitive processing (7,8). Seizure provocation through other stimuli and in patients with symptomatic epilepsies is less common, although perirolandic lesions are known to induce reflex seizures.A common assumption regarding reflex seizures is that hyperexcitable intracortical or corticosubcortical sensory circuits lead to fast and uninhibited recruiting and synchronization of neuronal pools (9-11). Converging clinical and experimental evidence suggests that malformations of cortical development (MCDs) are among the most hyperexcitable epileptogenic lesions (12,13). In addition, these malformations are often intrinsically epileptogenic

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Section: Discussionmentioning

confidence: 89%

Reflex Seizures in Patients with Malformations of Cortical Development and Refractory Epilepsy

Palmini

Halász²,

Scheffer

et al. 2005

Epilepsia

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“…Epilepsy associated with toothbrushing is an unusual form of reflex epilepsy in which seizures are precipitated exclusively by the act of brushing the teeth [53][54][55][56]. Such epilepsy involves a persistent rhythmic oral sensory stimulus, which is likely to evoke the neuronal synchronization necessary to induce seizures [57].…”

Section: Discussionmentioning

confidence: 99%

Is it safe to use a toothbrush?

Oliveira

Slot

Weijden

2014

Acta Odontologica Scandinavica

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The combined evidence related to serious adverse events as presented in case reports showed that the oral use of a toothbrush can be associated with ingestion, impaction, instant trauma, gingival traumatic injury and seizures. Given the incidence of reporting, important recommendations are that a toothbrush should not be used to induce vomiting, nor should people walk or run with this device in their mouths, especially children.

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“…Toothbrushing epilepsy is an unusual form of reflex epilepsy provoked by the act of toothbrushing. Seizures which began by facial motor or sensory manifestations and originated from the precentral or postcentral gyrus have been described in four distinct reports (Holmes et al, 1982; O'Brien et al, 1996; Koutroumanidis et al, 2001; Kanemoto et al, 2001). A medial temporal lobe origin was noted in another case associated with ictal orgasms (Chuang et al, 2004).…”

mentioning

confidence: 99%

Toothbrush‐Thinking Seizures

et al. 2006

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Summary: Seizures associated with toothbrushing have been reported in patients with precentral or postcentral partial epilepsy. Seizures precipitated by thinking have been described in patients with idiopathic generalized epilepsy. We report a patient with intractable partial epilepsy in which seizures were induced both by toothbrushing, and by seeing or thinking about toothbrush and toothpaste. Video-EEG analysis revealed a left temporal lobe origin for these reflex seizures. We discuss how complex multimodal stimuli may trigger these reflex seizures.

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Tooth Brushing–Induced Seizures: A Case Report

Cited by 24 publications

References 3 publications

Reflex Seizures in Patients with Malformations of Cortical Development and Refractory Epilepsy

Reflex Seizures in Patients with Malformations of Cortical Development and Refractory Epilepsy

Is it safe to use a toothbrush?

Toothbrush‐Thinking Seizures

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