TY  - JOUR
A1  - Frey, Katharina
A1  - Zöllner, Johann Philipp
A1  - Knake, Susanne
A1  - Oganian, Yulia
A1  - Kay, Lara
A1  - Mahr, Katharina Brigitte
A1  - Keil, Fee
A1  - Willems, Laurent Maximilian
A1  - Menzler, Katja
A1  - Bauer, Sebastian
A1  - Schubert-Bast, Susanne
A1  - Rosenow, Felix
A1  - Strzelczyk, Adam
T1  - Risk incidence of fractures and injuries: a multicenter video-EEG study of 626 generalized convulsive seizures
T2  - Journal of neurology
N2  - 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.
KW  - Epilepsy
KW  - Seizure
KW  - Morbidity
KW  - Fracture
KW  - Shoulder luxation
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/69235
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-692350
SN  - 1432-1459
N1  - Open Access funding provided by Projekt DEAL.
N1  - 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.
VL  - 267
IS  - 12
SP  - 3632
EP  - 3642
PB  - Steinkopff ; Springer
CY  - [Darmstadt] ; Berlin ; Heidelberg
ER  -