Epilepsy-related Tongue biting as another cause for recurrent oral ulcers

Sascha Meyer, Pediatrician, Child Neurologist,
December 05, 2013

Sascha Meyer (MD), Isabel Oster (MD), Sylvia Peterlini (MD), Ludwig Gortner (MD, Professor), Georg Kutschke (MD)

Dear Sir and Madam,

We read with interest the 15 minute consultation on recurrent oral ulceration in a child by Le Doare et al. (1). In their report, the authors provide a wide range of differential diagnoses that may lead recurrent oral ulcerations (1).

In our opinion, it is important to take into consideration other causes for oral ulcers in children - most importantly recurrent seizures (2, 3). This is of great importance because in addition to local treatment and use of a bite guard, administration of anti-epileptic drugs is of utmost importance. This medical problem is illustrated in Fig. 1 and Fig. 2.

With kind regards

Sascha Meyer, Isabel Oster, Sylvia Peterlini, Ludwig Gortner, Georg Kutschke

University Children`s Hospital of Saarlnd 66421 Homburg Germany

References: 1) Le Doare K, Hullah E, Challacombe S, Menson E. Fifteen-minute consultation: a structured approach to the management of recurrent oral ulceration in a child. Arch Dis Child Educ Pract Ed. 2013 Sep 19. doi: 10.1136/archdischild-2013-304471. [Epub ahead of print]. 2) Cerqueira DF, Vieira AS, Maia LC, Sweet E. Severe tongue injury in an adolescent with epilepsy: a case report. Spec Care Dentist. 2007 Jul- Aug;27(4):154-7. 3) Sanders BJ, Weddell JA, Dodge NN. Managing patients who have seizure disorders: dental and medical issues. J Am Dent Assoc. 1995 Dec;126(12):1641-7.

Figure 1: Multiple oral and tongue ulcers in a 2-year-old-girl

Figure 2: Sleep EEG recording demonstrating generalized seizure activity accompanied by a short episode of myoclonus, increased oral muscular tone, and bleeding from the oral cavity

Conflict of Interest:

None declared

Conflict of Interest

None declared