INTRODUCTION: Tongue wounds secondary to generalized tonic-clonic seizures are highly specific clinical signs of epileptic activity but remain underrecognized in dental and oral medicine/ surgery practice. Beyond their diagnostic value, these lesions may cause significant pain, functional impairment, and morbidity. Early recognition by oral health professionals may facilitate timely neurological evaluation and improve patient outcomes. METHODS: We report a case series of three patients referred to Oral Medicine and Oral and Maxillofacial Surgery services for traumatic wounds following convulsive seizures. Clinical presentation, management, and outcomes were analyzed. In addition, a structured narrative review of the literature was conducted to contextualize the findings and support the development of an interdisciplinary clinical algorithm. RESULTS: Traumatic lesions or wounds ranged from deep fissures with dental imprints and ecchymosis to extensive necrotic lesions requiring hospitalization, as well as complex lacerations requiring surgical suturing. Lesion severity was associated with seizure control and systemic comorbidities, including alcohol use disorder. These oral lesions acted as sentinel findings in undiagnosed or poorly controlled epilepsy and highlighted the need for coordinated neurological and oral management. The cases also emphasized the potential relevance of preventive dental evaluation and interdisciplinary follow-up in patients at risk of recurrent traumatic injuries. CONCLUSION: Post-convulsive oral wounds represent clinically significant and potentially severe manifestations of epilepsy that require more than isolated local management. We propose an interdisciplinary clinical algorithm integrating acute surgical care, neurological evaluation, and preventive dental strategies. This approach supports early diagnosis, reduces recurrence, and promotes improved patient-centered outcomes through coordinated care.
Pimentel-Solá et al. (Fri,) studied this question.