Katharina Frey, Johann Philipp Zöllner, Susanne Knake, Yulia Oganian, Lara Kay, Katharina Brigitte Mahr, Fee Keil, Laurent Maximilian Willems, Katja Menzler, Sebastian Bauer, Susanne Schubert-Bast, Felix Rosenow, Adam Strzelczyk
- 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.
MetadatenAuthor: | Katharina FreyORCiDGND, Johann Philipp ZöllnerORCiDGND, Susanne KnakeORCiDGND, Yulia OganianORCiD, Lara Kay, Katharina Brigitte MahrGND, Fee KeilORCiDGND, Laurent Maximilian WillemsORCiDGND, Katja MenzlerORCiD, Sebastian BauerORCiDGND, Susanne Schubert-BastORCiDGND, Felix RosenowORCiDGND, Adam StrzelczykORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-692350 |
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DOI: | https://doi.org/10.1007/s00415-020-10065-5 |
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ISSN: | 1432-1459 |
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Parent Title (English): | Journal of neurology |
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Publisher: | Steinkopff ; Springer |
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Place of publication: | [Darmstadt] ; Berlin ; Heidelberg |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2020/07/10 |
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Date of first Publication: | 2020/07/10 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2022/12/21 |
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Tag: | Epilepsy; Fracture; Morbidity; Seizure; Shoulder luxation |
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Volume: | 267 |
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Issue: | 12 |
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Page Number: | 11 |
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First Page: | 3632 |
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Last Page: | 3642 |
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Note: | Open Access funding provided by Projekt DEAL. |
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Note: | This study was supported by a LOEWE Grant from the State of Hessen for the “Center for Personalized Translational Epilepsy Research” (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany. |
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Institutes: | Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - CC BY - Namensnennung 4.0 International |
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