Bilateral posterior fracture-dislocation of the shoulders following epileptic seizures: a case report and review of the literature

Abstract

BackgroundBilateral posterior fracture-dislocation of the shoulders is an uncommon complication of grand mal seizures. We report a case of bilateral posterior dislocation of the shoulders with proximal humeral fractures following epileptic seizures. A posterior fracture-dislocation of the shoulder is very rare and can be caused by epileptic seizures, trauma, electrocution or electroconvulsive therapy.Case presentationA 62-year-old Sri Lankan male was admitted to our medical unit following four repeated generalized tonic–clonic convulsions, each lasting for several minutes. Following the second seizure he reported an inability to move both upper arms due to intense pain. There was no history of fall during the episodes of convulsions however but the bystanders have forcibly restrained his movements during the tonic–clonic convulsions. Clinical examination revealed severely restricted range of movement in both shoulders, with associated swelling and bruising of the shoulder joints and upper arms. Radiographs of the shoulders confirmed fractures at the level of surgical neck with posterior dislocation.ConclusionBilateral posterior fracture-dislocation of shoulders complicating epileptic seizures are rare. Forcible restraining of the patient’s upper limbs during seizures is the likely cause for the fracture dislocations in our patient and this had not been reported before.

Seizure Related Bilateral Humerus Neck Fracture: Case Report

“…[6][7][8][9][10] Nöbete bağlı omuz dislokasyonu ve humerus başı fraktürünün mekanizması ilk kez Shaw tarafından tanımlan-mıştır. 11 Nöbet sırasında omuzun tipik pozisyonu adduksiyon, internal rotasyon ve fleksiyondur.…”

Neglected Bilateral Anterior Shoulder Dislocation Following Epileptic Seizure: A Case Report and Literature Review

“…Myoskeletal injuries of the shoulder joint following epileptic seizures represent a relatively common entity. Posterior shoulder dislocation has been described as the most common [1]. However, a few anterior dislocation cases have been reported [1,2].…”

Posterior fracture dislocation of the proximal humerus

“…The combination of a posterior shoulder dislocation with a fracture of the proximal humerus occurs even less frequently. In most cases, the cause of these combination injuries is convulsive seizure, high-energy trauma such as a traffic accident, or electrical accident [5][6][7][8][9]. A common complication following a posterior fracture dislocation of the humerus is a locked position of the joint surface on the posterior glenoid rim [10,11].…”