Acetabular Central Fracture Dislocation after Generalized Seizure during Lumbar Myelography with Iohexol

Abstract

Fracture is a less common complication in seizure patients, and fractures as a consequence of convulsive seizures without direct trauma occur in 0.3% of cases. Acetabular fractures after convulsions are even more rare, and only a few cases of acetabular fracture dislocations, purely caused by convulsive activity, have been reported. Therefore, we report a case of unilateral acetabular central fracture dislocation after a seizure episode, with relevant literature review. The seizure attack occurred after contrast media (Iohexol) injection for checking the myelography.

Simultaneous bilateral shoulder and bilateral central acetabular fracture dislocation: What to do?

“…Central acetabular fracture dislocation is seen following high velocity road traffic accidents and rarely following episode of seizures. 11 , 12 , 13 , 14 , 15 , 16 , 17 Rath et al 16 in 1997 suggested that the mechanism of injury around the hip joint following seizures is due to severe uncontrolled muscle contraction of proximal thigh muscle leading to strong force towards the hip joint. Other factor includes severe osteoporosis due to old age and anti-eplietic medications can lead to acteabular fracture and central dislocation of the hip joint following seizures episodes without direct traumatic event.…”

“…Other factor includes severe osteoporosis due to old age and anti-eplietic medications can lead to acteabular fracture and central dislocation of the hip joint following seizures episodes without direct traumatic event. 1 , 2 , 11 , 12 , 13 , 14 , 15 , 16 , 17…”

“… 1 , 2 , 3 , 4 The possible mechanism of musculoskeletal injury following seizures is due to severe muscle contraction. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 Without direct trauma, simultaneous acetabular fracture and shoulder fracture dislocation are extremely rare. Central acetabular fracture is a complicated and life-threatening injury because of hypo-volume shock from severe blood loss.…”

“…Central acetabular fracture is a complicated and life-threatening injury because of hypo-volume shock from severe blood loss. 11 , 12 , 13 , 14 , 15 , 16 , 17 Musculoskeletal injuries following seizures have a high morbidity and mortality. 4 , 5 , 6 , 7 , 12 , 13 , 14 , 15 , 16 , 17 These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations.…”

“… 11 , 12 , 13 , 14 , 15 , 16 , 17 Musculoskeletal injuries following seizures have a high morbidity and mortality. 4 , 5 , 6 , 7 , 12 , 13 , 14 , 15 , 16 , 17 These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations. 1 , 2 , 3 , 4 , 5 , 6 , 15 , 16 , 17…”