Impact of seizure-related injuries on quality of life

Neurology, 2004

Background: Previous studies of injuries due to epileptic seizures predominantly involved patients with intractable epilepsy. These studies may have overestimated the risk of injuries in persons with epilepsy. Methods: Patients consisted of 247 Rochester, MN, residents who were diagnosed with epilepsy between 1975 and 1984. Seizurerelated injuries were defined as any injury, other than orolingual trauma, resulting from a seizure, sufficient for the patient to seek medical attention or for injury occurrence to be determined during the course of medical care. To identify risk factors for injury, characteristics of patients with seizure-related injury were compared with those without injury. Results: During a total of 2,714 patient-years of follow-up, 62 seizure-related injuries were identified in 39 patients (16%, one injury in every 44 person-years). Most injuries involved cranial soft tissue contusions or lacerations (79%). The majority of seizure-related injuries (82%) occurred during generalized convulsive seizures. Univariate analyses identified five potential risk factors for seizure-related injury: greater number of antiepileptic drugs used, less independent living situation, higher Rankin score, history of generalized convulsive seizures or drop attacks, and higher seizure frequency score. Seizure frequency, however, was the only significant risk factor identified by multivariate analysis (p Ͻ 0.001; relative risk, 1.33). Conclusions: This population-based study shows that seizure-related injuries are infrequent and generally of minor severity. In most epilepsy patients, excessive restriction of daily activities to avoid injury is unnecessary. Effective seizure control reliably reduces the risk of seizure-related injuries.

Epilepsia, 1997

Purpose: The increased risk of mortality among people with epilepsy is well documented; people with epilepsy are more likely than the general population to die as a result of an accident. Data about incidence of nonfatal accidents and associated factors are not so readily available, even though such accidents are more common than fatal injuries. We report the proportion of people who sustain various injuries during a seizure and the key variables predicting injury.

Neurology International, 2009

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 caregivers. 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.

Noro psikiyatri arsivi, 2013

INTRODUCTION The aim of the study was to evaluate injuries in patients with epilepsy and some factors associated with injury. METHODS This study included 126 epileptic patients who attended a neurology outpatient clinic of a hospital between March 2009 and March 2010. Data were collected using a patient information form and an injury evaluation form. The data were evaluated using percentage, mean and the Chi square test. RESULT 82.5% of patients have sustained injury due to an epileptic seizure. Soft tissue injuries were the most common (70.2%), followed by head injury (61.5%), dental and tongue injury (%58.6), burns (24%), and orthopaedic injury (21.2%). The most common site of burns were the upper extremities and the face (36% and 24%, respectively). Burns occurred during cooking in 32% of cases. Five patients had upper extremity fractures. Four patients faced the risk of bathtub drowning. The injuries usually occurred at home. The significant risk factors for injury were generali...

Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2006

To assess the frequency, characteristics, and risk of injury during seizure attacks. Questionnaire survey. Epilepsy out-patient clinic of the National Hospital for Neurology and Neurosurgery, Institute of Neurology, London. One hundred consecutive epileptic patients and their caretakers or relatives, who attended the hospital between 1 May and 30 June 2000. Details of epilepsy including the age of onset, causes, types, and number of seizures during the previous 12 months; injuries incurred as a result of seizures; and treatment required. The mean age of the 100 patients (38 male, 62 female) was 39 years (range, 16-78 years). Generalised tonic-clonic seizures occurred in 51% of patients and complex partial seizures in 40%. Hippocampal sclerosis was found in 12% of patients. Twenty-seven patients reported 222 seizure-related injuries. The total number of seizures per year was 4459 (mean, 45), of which 1094 (mean, 11) were with a fall (24.5%). Soft-tissue injury was the most common (61...

Current neurology and neuroscience reports, 2007

Epilepsy is associated with significantly increased morbidity and mortality from a variety of causes. Patients with epilepsy have approximately two to three times the risk of death from any cause compared with persons without epilepsy. Seizures may cause significant trauma, drowning, and accidental injury. Many of the deaths in persons with epilepsy are directly related to seizures, accidents and injuries arising from seizures, and the underlying condition resulting in seizures. This review focuses on recent data regarding seizure-related injury and mortality.

Epilepsia, 2010

Purpose: To compare the 1-year population-based incidence and types of injuries in persons with and without epilepsy. Methods: Three administrative databases (inpatient visits, physician claims, and emergency room visits) were linked from fiscal years 1996-2003 using a provincial insurance plan registry, which captures 99% of a population of 1.4 million in a large Canadian health region. Epilepsy cases (all age groups) from fiscal year 1996-2002 were identified. Three people without epilepsy were matched to one person with epilepsy for age (±1 year) and sex. Injuries were defined as any of 16 types of injuries for which medical attention was sought that occurred within fiscal year 2003. Results: Eight thousand eight hundred ninety subjects with epilepsy were identified and matched to 26,670 controls for age and sex. The mean age was 37.4 years (range 0.01-96.4 years), and 51.3% of subjects were male. The 1-year incidence of one or more injuries was 20.6% among persons with epilepsy and 16.1% among those without epilepsy (p < 0.001). Of the 16 types of injuries studied, 11 were higher in persons with epilepsy compared to those without epilepsy, and included fractures, crushing injuries, intracranial injuries, other types of head injuries, and multiple injuries. The difference was still significant after adjusting for age, gender, and comorbidities. Discussion: The 1-year incidence of injuries in this study was greater in persons with epilepsy compared to those without epilepsy, for nearly all injury types. Injury prevention should be discussed during routine visits in persons with epilepsy.

Seizure, 2012

Epilepsy & Behavior, 2013

Aim: To examine self-report data on seizure-related injuries and hospitalizations. Method: We analyzed data from the 2010 Australian Epilepsy Longitudinal Survey, distributed to registrants on the Australian Epilepsy Research Register. 343 responses were received (55% response rate), providing insight into experiences of living with seizures. This article examines self-report data on injuries related to seizures and hospitalizations. Results: 64% of those reporting injuries required hospital treatment. Respondents with seizure-related injuries had significantly earlier seizure onset, with risk of injury related to myoclonic and atonic seizures and currently taking 3 or more AEDs. Soft tissue injuries were the most frequently reported (85%), with 27% indicating facial injuries. Conclusions: The high rate of hospitalizations largely for soft tissue injuries suggests that access to more appropriate care was not available. Further research into care-seeking behavior by Australians suffering injury following seizure is required. Additionally, awareness of injury risks is important for appropriate self-management of epilepsy.

Epilepsia, 2008

Purpose: To identify the prevalence of injuries in people with epilepsy (PWE) in the general population. Method: We examined the prevalence of injuries obtained through the previously validated, door-todoor Canadian Community Health Survey (CHS) (n = 130,882). The 12-month weighted prevalence of injuries serious enough to limit normal activities was calculated for people with epilepsy and for the general population. Among those reporting injuries, variables of interest were compared in PWE and in the general population using risk ratios (RR) and their 95% confidence intervals (CI 95 ). Results: The 12-month weighted prevalence of injuries was not different in PWE (14.9%) and in the general population (13.3%) (RR: 1.1, CI 95 : 0.90-1.3). Among individuals reporting injuries, the only significant differences were a lower frequency of sports-related injuries in PWE (RR: 0.7, CI 95 : 0.4-0.9), and a three-times higher frequency of hospitalization following injuries in PWE (RR: 3.0, CI 95 : 1.3-4.7). Orthopedic injuries were the most frequent type of injury in both groups, but the differences were not significant. Although there were some trends, no significant differences between PWE and the general population were seen with regard to place where injury occurred, mechanism of injury, and number of injuries. Conclusions: The overall rate of injuries limiting activities did not differ between PWE and the general population. There was a higher rate of injuryrelated hospital admission in PWE, which could reflect that hospitalization is related to seizures and to comorbidities, and not injuries alone, or a more cautious attitude of clinicians towards injuries in PWE.