2024 American Academy of Neurology Abstract Website

Objective:

To provide the historical context behind a frequently propagated myth regarding best management of an actively seizing patient.

Background:

Despite ample evidence suggesting the harm of this practice, one of the most commonly held misconceptions among the general public regarding appropriate seizure care is the benefit of placing objects (typically padded or wooden) in the mouth of the patient to prevent self-harm. This finding is consistent across multiple cultures, with some surveys reporting as many as 74% of respondents subscribing to this belief. Given the ongoing prevalence of such descriptions in mass media, we aimed to identify the origin of this myth and track the path of its transformation into a cultural phenomenon.

Design/Methods:

Historical Review

Results:

Clear references to the placement of bite guards can be seen in English literature as far back as the 19^th century: with one of the earliest being the 1850 recommendations of John Comfort upon observing the frequency of tongue lesions in epileptic patients. Several authors appeared to have mirrored this sentiment in the years following, which may have been encouraged by unverified reports of patients swallowing their tongues when left unmanaged. By the mid-20^th century, however, medical consensus appears to have shifted somewhat due to increasing recognition of oral trauma caused by these interventions. Nonetheless, various official sources can be identified which continue to advocate for guard intervention for airway protection until the 1990s, after which time depictions continued to persist in television, novels, and other popular media.

Conclusions:

Public misinformation regarding the utility of bite guards in epileptic patients seems to have originated in the mid-19th century, which was afterwards perpetuated through both official medical channels and pop-culture depictions.