Post-traumatic oral necrosis in a patient with refractory epilepsy: A case report

Epilepsy patients can show a wide range of oral and maxillofacial injuries after seizures. However, the occurrence of oral soft tissue necrosis (OSTN) has been rarely reported. In the current report, a 55-year-old man with refractory epilepsy was referred for evaluation of an extensive injury in the oral mucosa after a severe seizure. Intraoral examination revealed a painless grayish-white necrotic area in the posterior region of the buccal mucosa on the left side measuring about 2×3 cm. Clinical findings led to the diagnosis of post-traumatic OSTN and the patient underwent surgical debridement on an outpatient basis. Two-month follow-up showed complete healing associated with the formation of fibrous tissue. A review of the literature demonstrated that post-traumatic OSTN was not reported among oral and/or maxillofacial injuries found in epilepsy patients. However, the current report reinforces that soft tissue necrosis may occur in the oral cavity of these patients after seizures. Post-traumatic OSTN should be considered an oral injury found in patients with refractory epilepsy.