CLINICAL AND THERAPEUTICAL ASPECTS OF GINGIVAL OVERGROWTHS INDUCED BY ANTICONVULSIVE DRUGS (PHENYTOIN)

INTRODUCTION Epilepsy is defined as a chronic disease with various etiologies, characterized by the recurrence of some convulsive or non-convulsive critical manifestations, inducing an abnormal discharge of the cerebral neurons, whichever the clinical and paraclinical - the associated EEG ones included - signs. Incidence of epilepsy Epilepsy is a chronic and invalidating pathology, affecting, according to WHO estimations issued in May 2015, approximately 50 million people all over the world, which defines it as one of the most frequent neurological diseases in all categories of age. Epilepsy: Causes The crises manifested before the age of 2 years are usually caused by high fever or by metabolic diseases, such as abnormal concentrations of blood glucose, calcium, magnesium, vitamin B6 or sodium. In spite of their efficiency, anticonvulsive drugs may have secondary effects, such as: anorexia, nausea, sickly feeling, epigastralgies, hirsutism and acne (in young women), alergic eruptions and, quite rarely, syndroms of colagenosis type, StevensJohnson, disseminated eritematous lupus, colestatic icterus, hepatic necrosis, hyperglycemia, osteomalacia (caused by the deficit of vitamin D), hemorrhages in new-borns (deficit of vitamin K), leukopenia, agranulocytosis, trombocytopenia, aplastic or megaloblastic anemia (deficit of folic acid), limphadenopathia and hypertrophic gingivitis. The basic lesion, manifested as a slow, progressive, benign volumic growth of the gingival tissues, a secondary effect of the therapy with phenytoin, was described in 1939 by Kimbell, who reported that 57% of the 119 patients under investigation showed various degrees of gingival overgrowth, associated with the treatment with phenytoin, recommended against epileptic attacks [11]. The first...