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Epilepsy and Local Anesthetic

I have a patient that needs a deep cleaning and he has epilepsy. He currently takes valproic acid and Dilantin and has symptoms of gingival hyperplasia because of this. Is it safe to use lidocaine or septocaine with epinephrine in patients with epilepsy and will this interfere with his medications? Are there any other precautions I need to take when treating a patient with epilepsy?

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1 Answer

According to Malamed, the stress of injections may provoke a seizure even in patients with well-controlled epilepsy. Appropriate stress reduction procedures should be employed. Severe local anesthetic overdose reactions manifest themselves as tonic-clonic convulsions. However, the administration of local anesthetic is not contraindicated in seizure-prone patients. Make sure to aspirate, as to not overdose local anesthesia.

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