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Open Access 01-12-2020 | Shoulder Luxation | Original Communication

Risk incidence of fractures and injuries: a multicenter video-EEG study of 626 generalized convulsive seizures

Authors: Katharina Frey, Johann Philipp Zöllner, Susanne Knake, Yulia Oganian, Lara Kay, Katharina Mahr, Fee Keil, Laurent M. Willems, Katja Menzler, Sebastian Bauer, Susanne Schubert-Bast, Felix Rosenow, Adam Strzelczyk

Published in: Journal of Neurology | Issue 12/2020

Abstract

Objective

To evaluate the incidence and risk factors of generalized convulsive seizure (GCS)-related fractures and injuries during video-EEG monitoring.

Methods

We analyzed all GCSs in patients undergoing video-EEG-monitoring between 2007 and 2019 at epilepsy centers in Frankfurt and Marburg in relation to injuries, falls and accidents associated with GCSs. Data were gathered using video material, EEG material, and a standardized reporting form.

Results

A total of 626 GCSs from 411 patients (mean age: 33.6 years; range 3–74 years; 45.0% female) were analyzed. Severe adverse events (SAEs) such as fractures, joint luxation, corneal erosion, and teeth loosening were observed in 13 patients resulting in a risk of 2.1% per GCS (95% CI 1.2–3.4%) and 3.2% per patient (95% CI 1.8–5.2%). Except for a nasal fracture due to a fall onto the face, no SAEs were caused by falls, and all occurred in patients lying in bed without evidence of external trauma. In seven patients, vertebral body compression fractures were confirmed by imaging. This resulted in a risk of 1.1% per GCS (95% CI 0.5–2.2%) and 1.7% per patient (95% CI 0.8–3.3%). These fractures occurred within the tonic phase of a GCS and were accompanied by a characteristic cracking noise. All affected patients reported back pain spontaneously, and an increase in pain on percussion of the affected spine section.

Conclusions

GCSs are associated with a substantial risk of fractures and shoulder dislocations that are not associated with falls. GCSs accompanied by audible cracking, and resulting in back pain, should prompt clinical and imaging evaluations.

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Title: Risk incidence of fractures and injuries: a multicenter video-EEG study of 626 generalized convulsive seizures
Authors: Katharina Frey
Johann Philipp Zöllner
Susanne Knake
Yulia Oganian
Lara Kay
Katharina Mahr
Fee Keil
Laurent M. Willems
Katja Menzler
Sebastian Bauer
Susanne Schubert-Bast
Felix Rosenow
Adam Strzelczyk
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Shoulder Luxation
Video-Electroencephalogram
Epilepsy
Published in: Journal of Neurology / Issue 12/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10065-5

At a glance: The STEP trials

Springer Medicine

Risk incidence of fractures and injuries: a multicenter video-EEG study of 626 generalized convulsive seizures

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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