Injuries in people with self‐reported epilepsy: A population‐based study

Téllez‐Zenteno, José F.; Hunter, Gary; Wiebe, Samuel

doi:10.1111/j.1528-1167.2007.01499.x

Cited by 51 publications

(58 citation statements)

References 34 publications

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“…5 In contrast, in the population-based Canadian Community Health Survey of adolescents and adults, persons with epilepsy had higher rates of injury related hospitalizations compared with the general population despite having a similar 12-month weighted prevalence of injuries. 16 …”

Section: Discussionmentioning

confidence: 99%

“…4,5,7,14,16,17 In a population-based study of seizure-related injuries amongst adults and adolescents with epilepsy, the cumulative risk of seizure-related injury at 10 years was 14.6% (CI 9.5–19.3). 14 Further, less than 5% of injuries over 12 months were attributable to seizures in a prospective study of injuries in children with epilepsy.…”

Section: Discussionmentioning

confidence: 99%

“…3 Although several studies have examined injuries in children with epilepsy, 4–19 the majority focused on clinic or hospital-based and often refractory samples. 4,5,8,9,17,19 Even though studies of injuries of children with epilepsy (or including children with epilepsy) have included population-based samples, 6,10,11,13–16,18 a limited number included control samples, some of which only focused on one injury or epilepsy type, and most such studies demonstrated higher rates of injury in children with epilepsy compared with controls. 10,13,15,16,18 …”

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confidence: 99%

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Injuries in Adolescents with Childhood-Onset Epilepsy Compared with Sibling Controls

Baca

Vickrey

Vassar

et al. 2013

The Journal of Pediatrics

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Objective To compare the occurrence of injuries in adolescents with childhood-onset epilepsy and matched sibling controls. Study design Retrospective case-control lifetime injury assessments were obtained from a community-based cohort of adolescents with childhood-onset epilepsy diagnosed 9-years earlier, and their siblings. Children with epilepsy (n=501; mean age 15.3 years) included children with complicated (abnormal neurological exam or IQ<80; n=133) and uncomplicated (normal neurological exam and IQ≥80; n=368) epilepsy. Children with uncomplicated epilepsy were matched to sibling controls (n=210 pairs). Children reported whether they had ever (before and after epilepsy diagnosis) experienced injuries, “serious enough to require medical attention” and the type of treatment required. Results 49.1% of children with epilepsy experienced any injury, of whom 8.9% required surgery/hospitalization and 17.1% had an injury due to a seizure; fewer children with uncomplicated epilepsy had seizure-related injuries versus those with complicated epilepsy (13.6% vs. 27.4%; p≤0.01). The proportion of children with epilepsy with any injury by types (not mutually exclusive) were: 25.2% (n=126) fractures, 24.4% (n=122) head, 10.2% (n=51) other, 8.4% (n=42) dental and 8% (n=40) burns/scalds. A similar proportion of children with uncomplicated epilepsy experienced any injury (overall and by type) compared with matched sibling controls, with the exception that more children with uncomplicated epilepsy had head injuries (30.0% vs. 19.5%; p<0.02). Conclusion With the exception of head injuries, in a representative cohort of children with epilepsy compared with siblings there was no evidence of an increased risk of injury. This may reflect that the sample was not biased to more severe cases or that safety precautions to prevent injury were widely employed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Injuries in Adolescents with Childhood-Onset Epilepsy Compared with Sibling Controls

Baca

Vickrey

Vassar

et al. 2013

The Journal of Pediatrics

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“…1 These may be due to interictal EEG epileptiform discharges occurring in the absence of obvious clinical seizure activity. 2,3 PWE are more likely to die as a result of an accident than non-epileptic patients, and a person with epilepsy has a 5% chance per year of visiting an emergency department due to a seizure-related injury. 4,5 …”

Section: Introductionmentioning

confidence: 99%

Injuries in epilepsy: a review of its prevalence, risk factors, type of injuries and prevention

Téllez‐Zenteno¹,

Nguyen²

2009

Neurol Int

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Currently, there is intense clinical research into various aspects of the medical risks relating to epilepsy, including total and cause-specific mortality, accidents and injuries in patients with epilepsy and mortality related with seizures. Seizures occurring in precarious situations and resulting in injuries are still an important concern for patients with epilepsy, their employers and their care-givers. Submersion injuries, motor vehicle accidents, burns, and head injuries are among the most feared epilepsy-related injuries. These concerns seem valid because the hallmark of epilepsy, episodic impairment of consciousness and motor control, may occur during interictal EEG epileptiform discharges, even in the absence of a clinical seizure. In addition, psychomotor comorbidity and side effects of antiepileptic drugs may contribute to the risk of injuries in patients with epilepsy. Published risk factors for injuries include the number of antiepileptic drugs, history of generalized seizures, and seizure frequency. In general, epidemiological information about incidence of injuries has been conflicting and sparse. In general, studies focusing on populations with more severe forms of epilepsy tend to report substantially higher risks of injuries than those involving less selected populations. On the other hand, studies based on non-selected populations of people with epilepsy have not shown an increased frequency of injuries in people with epilepsy compared with the general population. Some studies have shown that patients with epilepsy are more frequently admitted to the hospital following an injury. Possible explanations include: more cautious attitude of clinicians toward injuries occurring in the setting of seizures; hospitalization required because of seizures and not to the injuries themselves; and hospitalization driven by other issues, such as comorbidities, which are highly prevalent in patients with epilepsy. Potentially the high rate of hospitalizations could be related with the severity of the injury. This article reviews the best available epidemiological information about injuries, including incidence and risk factors. Also this article reviews information about specific types of injuries such as fractures, burns, concussions, dislocations, etc. Information about accidents in people with epilepsy is also discussed.

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“…In a Canadian population-based study, patients with epilepsy appeared to have more domestic-related injuries, although sports-related injuries occurred in these patients less often for the unfortunate reason of them having fewer opportunities to participate in sport, which again impacts on their health. 33 The biggest difference in comparison with the general population can be seen in terms of premature death with a four to eightfold higher risk of premature death. 34,35 One of the reasons for the greater risk of premature death in people with epilepsy is the raised risk of suicide in those patients with comorbid psychiatric disease.…”

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confidence: 99%

Treating Drug-resistant Epilepsy – Why are we Waiting?

Boon

Ryvlin

Wheless³

et al. 2015

European Neurological Review

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Drug-resistant epilepsy (DRE) has been defined by the ad hoc Task Force of the International League Against Epilepsy (ILAE) Commission on Therapeutic Strategies as the failure of two appropriately chosen and tolerated anti-epileptic drugs (AEDs) (whether as monotherapy or in combination) to control seizures when used for an adequate period of time. The difference between the number of patients with DRE and the number of these patients who do not get access to adequate treatment is defined as the 'treatment gap', which is considered to be substantial.There are multiple possible causes that underlie the treatment gap in DRE: economic costs, natural history of epilepsy, deficiencies in health service provision, social stigma and other as yet unidentified causes. Factors affecting quality of life in DRE include depression and anxiety, raised risk of mortality and morbidity, increased healthcare utilisation and increased risk of adverse events with long-term use of AEDs, cognitive and memory impairment, seizure-related injuries, impaired ability to achieve educational and vocational goals, to drive, establish families and benefit from social relationships. Among the reasons for the greater risk of premature death are the raised risk of suicide in those patients with comorbid psychiatric disease and the increased incidence of sudden unexpected death among those with epilepsy. Managing epilepsy well involves more than just seizure reduction and when freedom from seizures cannot be achieved, addressing quality of life is likely to be more beneficial than interventions aimed at seizure reduction alone. Options exist for patients with DRE who are not candidates for epilepsy surgery, including dietary treatments, further attempts with AEDs and non-pharmacological interventions with devices. Further, non-invasive modalities are emerging, creating a more hopeful picture that the treatment gap for patients with DRE may be narrowed or even closed.

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Injuries in people with self‐reported epilepsy: A population‐based study

Cited by 51 publications

References 34 publications

Injuries in Adolescents with Childhood-Onset Epilepsy Compared with Sibling Controls

Injuries in Adolescents with Childhood-Onset Epilepsy Compared with Sibling Controls

Injuries in epilepsy: a review of its prevalence, risk factors, type of injuries and prevention

Treating Drug-resistant Epilepsy – Why are we Waiting?

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