Seizure‐related injuries in people with epilepsy: A cohort study from Saudi Arabia

Abstract

Objectives: Patients with epilepsy have a high risk of accidents and injuries, resulting in minimized physical activity and social withdrawal. Therefore, we surveyed the prevalence and the types of injuries that patients with epilepsy may endure, and the factors that may increase the risk of injuries. Methods:In this cohort study, adult and pediatric patients diagnosed with epilepsy (age ≥ 7 years) and a close family member (parents/guardian) attending the outpatient epilepsy clinics at King Fahd Medical City (Riyadh, Saudi Arabia) were interviewed by neurologists. They reviewed the patients' medical records and administered a structured questionnaire to identify and compare several variables, including injury frequency versus seizure type and seizure frequency, number of antiseizure medications used, medication compliance, and work and social limitations.Results: Out of 200 patients, 86 (43%) sustained injuries during an attack of their habitual seizures. Almost half of this group showed a tendency for recurrent injuries. The most common traumas were soft tissue injury (36.5%), head injury (32%), dental injury (8.5%), burns (7%), dislocation (7%), fractures (6.5%), and submersion (2%). Two-thirds of the patients had their injury at home. 64% of patients who had seizures for more than 10 years sustained multiple injuries (P = .003). Injury frequency was higher among patients with daily or monthly seizures (P = .03). 76% of patients who suffered injuries more than twice had generalised tonic-clonic seizures, and genetic generalised epilepsy was encountered more in injured patients (P = .02). Also, patients on polytherapy were more likely than those on monotherapy to have an injury (P = .003).Significance: Two-fifths of the patients reported seizure-related injuries. The most common were soft-tissue injuries and head traumas, while homes were the most frequent site. In addition, longer epilepsy duration, generalized tonicclonic seizures, and polytherapy were associated with a higher prevalence of injuries. Therefore, injury prevention strategies should be developed for PWE, especially for those at higher risk.

Fractures in people with epilepsy: A nationwide population‐based cohort study

“…28 Comparisons of prevalence and incidence rates of all and site-specific fractures in our study with those of previous work are limited because most studies have been done in specialized epilepsy centers or long-stay care facilities; or use different methodology (eg, self-administered questionnaire). 4,15,16,[30][31][32][33] Incidence rates of fractures among PWE in our study was somewhat higher than in population-based studies using the UK General Practice Research Database (GPRD). 18 Difference might be due to population included as follows: GPRD data might not include individuals in long-term care facilities, and that population has a considerably higher risk of falls and fractures; on the contrary, in our study, every PWE who required medical care for a fracture was included.…”

“…Comparisons of prevalence and incidence rates of all and site‐specific fractures in our study with those of previous work are limited because most studies have been done in specialized epilepsy centers or long‐stay care facilities; or use different methodology (eg, self‐administered questionnaire) 4,15,16,30–33 . Incidence rates of fractures among PWE in our study was somewhat higher than in population‐based studies using the UK General Practice Research Database (GPRD) 18 .…”

“…1,2 Fractures in PWE might be result of seizure-related impairment of consciousness followed by falls and fall-related injuries. [3][4][5] Vigorous muscle contractions during generalized tonicclonic seizures (GTCS) can cause joints dislocations and fractures as well. 3 Furthermore, chronic antiseizure medication (ASM) treatment impedes bone metabolism, which increases bone fragility and elevates fragility fracture risk.…”

“…Bone fractures can lead to disability and impaired quality of life, and in people with epilepsy (PWE) are associated with an elevated mortality rate 1,2 . Fractures in PWE might be result of seizure‐related impairment of consciousness followed by falls and fall‐related injuries 3–5 . Vigorous muscle contractions during generalized tonic‐clonic seizures (GTCS) can cause joints dislocations and fractures as well 3 .…”

Implementation of a Morphological Filter for Removing Spikes from the Epileptic Brain Signals to Improve Identification Ripples

“…around 40% of epilepsy-affected patients suffer its drug-resistant version, which significantly limits potential treatment methods [ 1 , 2 , 3 , 5 , 8 ]. It affects the life quality of people affected with it in a significant way, as the seizures occur unexpectedly and can cause various physical injuries or even death [ 6 , 9 , 10 , 11 , 12 , 13 , 14 ]. Is is diagnosed usually by analysis of electroencephalography (EEG) signals [ 6 , 15 , 16 , 17 ], which can be recorded either from the scalp (surface) or via intracranial EEG (iEEG) [ 6 , 18 , 19 , 20 , 21 ].…”