ABSTRACT
Hong Kong Med J 2006;12:260-3 | Number 4, August 2006
ORIGINAL ARTICLE
Seizure-related injury in an adult tertiary epilepsy clinic
S Tiamkao, SD Shorvon
Division of Neurology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
OBJECTIVE. To assess the frequency, characteristics, and risk of injury during seizure attacks.
DESIGN. Questionnaire survey.
SETTING. Epilepsy out-patient clinic of the National Hospital for Neurology and Neurosurgery, Institute of Neurology, London.
PATIENTS. One hundred consecutive epileptic patients and their caretakers or relatives, who attended the hospital between 1 May and 30 June 2000.
MAIN OUTCOME MEASURES. Details of epilepsy including the age of onset, causes, types, and number of seizures during the previous 12 months; injuries incurred as a result of seizures; and treatment required.
RESULTS. The mean age of the 100 patients (38 male, 62 female) was 39 years (range, 16-78 years). Generalised tonic-clonic seizures occurred in 51% of patients and complex partial seizures in 40%. Hippocampal sclerosis was found in 12% of patients. Twenty-seven patients reported 222 seizure-related injuries. The total number of seizures per year was 4459 (mean, 45), of which 1094 (mean, 11) were with a fall (24.5%). Soft-tissue injury was the most common (61%), followed by burns (17%), head injury (14%), orthopaedic injury (5%), and injuries in water (3%). The most common site of soft-tissue injury and burns were to the face: 49% and 38% respectively. Burns occurred during cooking in 78% of cases. Two patients had skull fractures. Orthopaedic injuries usually occurred at home (73%). In cases of seizures in water, five of six occurred while swimming. Injury occurred once in every 20 seizures, every 11 generalised tonic-clonic seizures, and every five seizures with a fall. The significant risk factors for injury were generalised tonic-clonic seizures, high frequency of seizures, and seizures with a fall.
CONCLUSION. Soft-tissue injury was the most common seizure-related injury. Injury occurred once in every 20 seizures. The risk factors were generalised tonic-clonic seizures, high frequency of seizures, and seizures with a fall.
Key words: Risk factors; Seizures; Soft tissue injuries
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