Summary: 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.Methods: Questionnaires were mailed to an unselected, community-based population of patients with epilepsy. The questionnaire included clinical and demographic details, previously validated scales of psychosocial well-being, and questions about seizure-related injuries.Results: Of patients who had had at least one seizure during the previous year, 24% sustained at least one head injury, 16% sustained a burn or scald, 10% a dental injury, and 6% some other fracture. Seizure type, seizure severity, and seizure frequency were key predictors of having sustained at least one of these four seizure-related injuries. Key predictors of budscald were seizure severity, seizure frequency and sex; those of head injury were seizure severity and type; that of dental injury was seizure severity; and those of some other fracture were seizure severity, duration of epilepsy, and three or more drug-related adverse effects.Conclusions: These data help identify significant risk factors associated with seizure-related injuries and so facilitate sensible patient counseling about how the risks of such injuries can be minimized. Key Words: Epilepsy-Accidents-Head injury-Dental injury-Burns.People with epilepsy have an increased risk of mortality as compared with the general population, and accidents and trauma appear to be a more common cause of death in people with epilepsy than in the population as a whole (1). Investigators have studied drowning during seizures in particular, and people with seizures are significantly more likely to die as a result of drowning than are those without seizures (1,2). Relatively little has been reported in the literature to date about the incidence and nature of nonfatal seizure-related injuries, but one recent survey (3) offers some information on the level of seizure-related injury in a general population: Of 146,365 visits to four emergency departments, 0.4% were precipitated by seizures and 14% of these seizures resulted in injury. In all, seizure-related injuries were sustained by 63 patients, and some of the patients incurred multiple injuries as a result of their seizures. Head contusions and lacerations were the most common injuries sustained; most injuries were minor, requiring little or no treatment. That study and others showed that head injuries and bums tend to be the most common types of seizure- related injury (4,5). Factors associated with the likelihood of sustaining an injury because of a seizure include seizure type, seizure frequency, number of seizures during lifetime, and patients' sex (6-8).We attempt to add to t...