Reactive bite-related tongue lesions in cognitively impaired epilepsy patients: A report of two cases
Tongue bites frequently occur during seizures in epilepsy patients. We report two cases of cognitively impaired Lennox-Gastaut syndrome patients with reactive lesions on the tongues. Case 1 was a 30-year-old man whose chief complaint was mouth pain. Local finding was a small bean-sized pedunculated mass on the tongue, histopathologically diagnosed as inflammatory fibrous hyperplasia. Case 2 was a 45-year-old man whose chief complaint was bleeding from the mouth. His clinical finding was blood loss anemia. Local finding was a 20-mm-diameter pedunculated mass on the tongue, histopathologically diagnosed as pyogenic granuloma. These mass lesions were believed to be reactive, caused by repetitive minor damage involving reparative fibrous tissue response. Therefore, the two cases may have involved reparative responses to mucosal injury incurred by accidental bites during epileptic seizures. Intellectual disability made medical treatment difficult and had allowed the massive lesions to form. It is necessary for cognitively impaired epilepsy patients to undergo regular dental examinations in order to get used to dental checks and to increase the number of intraoral observations in the context of close cooperation between dentists and epilepsy therapists.