Prevalence, risk factors and therapeutic aspects of injuries and accidents in women with epilepsy

Verboket, René D.; Söhling, Nicolas; Marzi, Ingo; Paule, Esther; Knake, Susanne; Rosenow, Felix; Strzelczyk, Adam; Willems, Laurent M.

doi:10.1007/s00068-018-1030-8

Cited by 17 publications

(7 citation statements)

References 44 publications

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“…We found a correlation between injuries and older age in females, a finding that might be attributed to a higher prevalence of osteoporosis in older women [31,32]. However, epilepsy patients in general have a high risk of developing bone disease, caused by ASD intake as well as other factors [33,34].…”

Section: Discussionmentioning

confidence: 58%

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

et al. 2020

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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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Section: Discussionmentioning

confidence: 58%

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

et al. 2020

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“…The most consistent findings regarding risk factors for injuries are occurrence of generalized convulsive seizures (focal to bilateral or generalized tonic-clonic seizures) 21,22,30,33 , but atonic seizures and ictal falls have also been associated with increased risks 21,33,34 . Intractable epilepsy, uncontrolled seizures, or high seizure frequency are also consistent risk factors for seizure-related injuries [21][22][23]31,35 . Polytherapy with AEDs was reported to be associated with increased risk in a few studies 21,31,34 although it is not clear if polytherapy is a risk factor as such or just a reflection of a more difficult to treat epilepsy with poor seizure control.…”

Section: Risk Factorsmentioning

confidence: 99%

Dramatic outcomes in epilepsy: depression, suicide, injuries, and mortality

Mesraoua

Deleu

Hassan

et al. 2020

Current Medical Research and Opinion

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In this narrative review, we will discuss some of the significant risks and dramatic consequences that are associated with epilepsy: depression, suicide, seizure-related injuries, and mortality, both in adults and in children. Considering the high prevalence of depression among people with epilepsy (PWE), routine and periodic screening of all PWE for early detection and appropriate management of depression is recommended. PWE should be screened for suicidal ideation regularly and when needed, patients should be referred for a psychiatric evaluation and treatment. When starting an antiepileptic drug (AED) or switching from one to another AED, patients should be advised to report to their treating physician any change in their mood and existence of suicidal ideation. The risk of injuries for the general epilepsy population is increased only moderately. The risk is higher in selected populations attending epilepsy clinics and referral centers. This being said, there are PWE that may suffer frequent, severe, and sometimes even life-threatening seizure-related injuries. The most obvious way to reduce risk is to strive for improved seizure control. Finally, PWE have a 2-3 times higher mortality rate than the general population. Deaths in PWE may relate to the underlying cause of epilepsy, to seizures (including sudden unexpected death in epilepsy [SUDEP] and seizure related injuries) and to status epilepticus, as well as to other conditions that do not appear directly related to epilepsy. Improving seizure control and patient education may be the most important measures to reduce epilepsy related mortality in general and SUDEP in particular.

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“…Um dieser gerecht zu werden und um Vergütungsdefizite offen zu legen, werden einzelne Leistungen anhand ihrer Wirtschaftlichkeit analysiert [7]. Bisher durchgeführte Untersuchungen konzentrierten sich vor allem auf besondere Krankheitsbilder, polytraumatisierte Patienten oder bildeten die Gesamtkosten der ambulanten Notfallversorgung ab [12,21,22,[25][26][27]. Für die allgemeine Notfallversorgung konnte ein fallbezogener Erlös von 32 € bei durchschnittlichen Kosten von 120 € aufgezeigt werden.…”

Section: Regredienz Von Notfällen Im Kassenärztlichen Bereitschaftsdiunclassified

Kosten-Erlös-Defizit der ambulanten Versorgung von Kopfplatzwunden in der Notaufnahme

Mühlenfeld

Schindler

Sterz

et al. 2020

Chirurg

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Prevalence, risk factors and therapeutic aspects of injuries and accidents in women with epilepsy

Cited by 17 publications

References 44 publications

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

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

Dramatic outcomes in epilepsy: depression, suicide, injuries, and mortality

Kosten-Erlös-Defizit der ambulanten Versorgung von Kopfplatzwunden in der Notaufnahme

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