Seizure-Related Injuries among People with Epilepsy at the Outpatient Department of the University of Gondar Hospital, Northwest Ethiopia: Cross-Sectional Institutional-Based Study

Abstract

Background The characteristics of epilepsy such as the episodic nature of impairment of consciousness and motor control, psychomotor comorbidity, seizure frequency, and side effects of antiepileptic drugs impact negatively on the physical safety of the patients. Physical injuries such as burn, fracture, dental loss, and hemorrhage affect the quality of patients' life to the extent of death. Thus, the main purpose of this study was to assess the prevalence of physical injury and associated factors among people with epilepsy. Methods The study was carried out among 409 people with epilepsy. Cross-sectional study design was utilized to enroll the selected study participants using systematic random sampling technique. Binary and multivariable logistic regression were fitted to identify associated factors using an odds ratio and 95% CI. Results The overall estimated prevalence of seizure-related physical injury was found to be 27.9%. Of the 27.9% seizure-related physical injuries, 12.5% had abrasions, 5.9% had burns, 4.4% had dental injuries, 2.2% had fractures, and 1.5% had head injuries and dislocations, respectively. Employment, 2-3 years duration of illness, seizure frequencies, and frequencies of drug taken were factors associated with physical injury. Conclusion More than a quarter of the study participants experienced physical injury. Designing/strengthening injury prevention strategies is suggested especially for those who had uncontrolled seizure frequency for longer period of time.

<p>Antiepileptic Drug Treatment Outcomes and Seizure-Related Injuries Among Adult Patients with Epilepsy in a Tertiary Care Hospital in Ethiopia</p>

“…6 Physical injuries are common among people with epilepsy compared to the general population and the occurrences of physical injury has a negative impact on the quality of life among patients with epilepsy and a higher mortality rate compared to the general population. 7 Treatment outcome is affected by several factors including drug-related factors, disease-related factors and patient-related factors. Drug-related factors include pharmacokinetics of the drugs, drug-drug interactions and toxicity among others.…”

Association between epilepsy and oral maxillofacial trauma: A systematic review and meta‐analysis

“…In relation to injuries of facial soft tissues in epileptic patients, the literature indicates prevalences varying from 5% to 95% . On the other hand, the prevalence of dental trauma ranged from 1% to 54% . This large range reinforces the relevance of the compiled result to determine the prevalence of oral and maxillofacial injuries in epileptic individuals, as well as to clarify the nature of the evidence.…”

“…Considering all included studies, a total of 7277 patients were screened to evaluate the influence of epilepsy on the occurrence of oral and maxillofacial injuries. The full process of study selection is illustrated in Figure .…”

“…Thus, the use of AEDs becomes a significant variable to consider in the context of the occurrence of physical injuries resulting from epilepsy. However, among the 30 studies included in this review, only three concerned with the data analysis by adjusting them to the use of these drugs . Therefore, it is suggested that further studies with a prospective longitudinal design can be developed in order to verify if the adverse events of AEDs could increase the prevalence of oral and maxillofacial injuries among epileptic individuals.…”

“…However, among F I G U R E 4 Meta-analysis showing the chance for oral and maxillofacial trauma for epileptics when comparing to special needs, nonepileptics and PNES subjects the 30 studies included in this review, only three concerned with the data analysis by adjusting them to the use of these drugs. 4,9,21 Therefore, it is suggested that further studies with a prospective longitudinal design can be developed in order to verify if the adverse events of AEDs could increase the prevalence of oral and maxillofacial injuries among epileptic individuals. In addition, clarifying the efficacy and safety of these drugs in clinical practice becomes important to assist in the prevention of the occurrence of physical injuries in general.…”