Authors :
Presenting Author: Naeem Mahfooz, MD – University of Toledo
Gulbudin Muhammad, MD – University of Toledo
Jamie Stout, MD – University of Toledo
Saba Tariq, MD – University of Toledo
Irum Hina, MD – University of Toledo
Mariam noor, MD – University of Toledo
Ajaz Sheikh, MD – University of Toledo
mehmood rashid, MD – University of Toledo
Rationale:
Epilepsy is a neurological disorder with multifactorial etiologies, including genetic and structural factors, but environmental factors are increasingly recognized as contributors. This case series examines three pediatric cases where seizures emerged following the placement of silver-containing dental implants. One patient had a genetic mutation, another was negative for genetic mutations, and the third was not tested.
Methods: N/A
Results:
A 9-year-old female with generalized tonic-clonic and dialeptic seizures following silver dental spacers. Video EEG monitoring revealed generalized epilepsy with spike and wave discharges predominantly in the bifrontal region. She needed 3 anti-seizure medications (ASM) to control seizures. She showed improvement after spacer removal and was weaned off anti-seizure medications with normalization of EEG. Genetic testing showed heterozygous pathogenic mutation in the SGSH gene.
An 11-year-old male with seizures beginning after silver dental implants at age 5, with focal epilepsy confirmed by EEG which revealed focal epilepsy with right central temporal sharp waves, and long-term video EEG monitoring, which confirmed sporadic epileptic discharges without correlating seizures during monitoring. His sister (Case 3) had a similar history of seizures following silver implants.
A 13-year-old female with seizures starting after silver dental restoration at age 7. She experienced various seizure types, with positive EEG finds, negative MRI findings and unremarkable genetic testing. Both Case 2 and 3 are on anti-seizure medication and carry dental implants.
Conclusions:
These cases suggest a potential link between silver dental implants and seizure onset, with familial sensitivity or genetic predisposition in some cases. These findings emphasize the need for further investigation into the neurotoxic effects of silver and the importance of obtaining a thorough dental history when evaluating patients with seizures. Dental professionals should exercise caution when selecting silver implants, and neurologists should consider dental factors in their assessments of every patient presenting with seizures.Funding: None