Abstract
Purpose:Epileptic seizures frequently result in distinct physical injuries,fractures,traumatic brain in-juries and minor trauma.The aim of this study was to retrospectively determine the frequent injury patterns due to seizure episode and to analyze consecutive acute medical care.Methods:This retrospective mono-center study was conducted at Frankfurt University Hospital,Frank-furt am Main,Germany between January 2007 and December 2017.Epilepsy patients with seizure-related fractures admitted to the emergency department were identified via a retrospective systematic query in the hospital information system using the ICD-10 German modification codes G40.0-G40.9.Patients with an unclear diagnosis of epilepsy were excluded.Sociodemographic as well as disease specific aspects were analyzed.Descriptive and Kruskal-Wallis one-way analysis of variance were used for statistical analysis.Results:A total number of 62 epilepsy patients were included.The mean age was 58.1 years.Fractures concerned the upper extremity most frequently(43.5％,n=20),and 70.0％(14/20)were humerus fractures.Admission to intensive care unit for acute trauma care was necessary in 29.0％patients(n=18),and surgery in 45.2％patients(n=28).Twenty-five patients(26.6％)showed clinical or radiological signs of traumatic brain injury.Provoking factors were identified in 20 patients(32.3％),i.e.,acute withdrawal or excess of alcohol(n=15),relevant sleep deprivation(n=2),and intoxication or withdrawal of other illegal drugs or trivial infect(n=1 for each)and non-compliance with anti-seizure drugs(n=1).A decreased T-score(-1.04±1.15)and Z-score(-0.84±0.75)compared to healthy subjects were found.Conclusion:Fractures in upper extremities,trunk and craniocerebral trauma occur frequently as seizure-induced injuries.Alcohol excess and withdrawal are important provoking factors and should be targeted with preventive measurements to avoid seizure related injuries and accidents.
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