Injury Among Children and Young Adults With Epilepsy

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Injuries in children and young adults commonly cause morbidity and mortality. Epilepsy is common among children. Injury risk may be greater among those with epilepsy, but there are few large, population-based studies, making it difficult to estimate risk. WHAT THIS STUDY ADDS:Children and young adults with epilepsy are at a greater risk of medicinal poisonings, thermal injuries, and fractures than those without epilepsy. Young adults with epilepsy are at particularly high risk of medicinal poisonings. abstract OBJECTIVE: To investigate whether children and young adults with epilepsy are at a greater risk of fracture, thermal injury, or poisoning than those without. METHODS:A cohort study was conducted by using the Clinical Practice Research Datalink (1987Datalink ( -2009), a longitudinal database containing primary care records. A total of 11 934 people with epilepsy and 46 598 without, aged between 1 and 24 years at diagnosis, were followed for a median (interquartile range) of 2.6 (0.8-5.9) years. The risk of fractures (including long bone fractures), thermal injuries, and poisonings (including medicinal and nonmedicinal poisonings) was estimated. RESULTS:Adjusting for age, gender, Strategic Health Authority region, deprivation, and calendar year at study entry (and, for medicinal poisonings, behavior disorder), people with epilepsy had an 18% increase in risk of fracture (hazard ratio [HR] = 1.18; 95% confidence interval [CI], 1.09-1.27), a 23% increase in risk of long bone fracture (HR = 1.23; 95% CI, 1.10-1.38), a 49% increase in risk of thermal injury (HR = 1.49; 95% CI, 1.27-1.75), and more than twice the risk of poisoning (HR = 2.47; 95% CI, 2.15-2.84), which was limited to poisoning from medicinal products (medicinal HR = 2.54; 95% CI, 2.16-2.99; nonmedicinal HR = 0.96; 95% CI, 0.61-1.52).CONCLUSIONS: Children and young adults with epilepsy are at a greater risk of fracture, thermal injury, and poisoning than those without. The greatest risk is from medicinal poisonings. Doctors and other health care professionals should provide injury and poison prevention advice at diagnosis and epilepsy reviews. Pediatrics 2014;133:827-835

Brief Report: Bone Fractures in Children and Adults with Autism Spectrum Disorders

“…These include attention deficit disorder (ADHD) (Chou et al 2014) and seizure disorder (Prasad et al 2014), and the contribution of these comorbid diseases to fracture risk in ASD needs to be determined. Poor awareness of risky behavior, developmental disabilities (Glick et al 2005) and delayed reaction responses could further contribute to the increased risk for fracture in children with ASD, and may impact certain sites more than others.…”

Band-sensitive seizure onset detection via CSP-enhanced EEG features

“…The EEG activity of clinical relevance is limited to the frequency band 0.5-50 Hz; however, the frequency range that captures various seizure onset electrographic manifestations is 0.5-25 Hz. The subband signals that collectively represent the activity at timescales corresponding to the seizure frequencies are the δ, θ, α, and β EEG frequency bands, where δ b 4 Hz, θ ∈ [4,7] Hz, α ∈ [8,15] Hz, and β ∈ [16,31] Hz.…”

“…For the purpose of seizure detection, only subband signals {d 4 , and d 7 [n] correspond to the β, α, θ, and δ bands, respectively. This is evident from the frequency response of the cascaded filters shown in Fig.…”

“…Injuries such as fractures, head injuries, and burns are commonly exhibited by patients with epilepsy because of the confusion, loss of consciousness, and lack of muscle control that accompany certain types of seizures. A device that can reliably detect or predict the onset of seizure episodes and warn the patient of an imminent seizure can greatly mitigate the risk of injury associated with epileptic episodes and enable patients with epilepsy to lead a more normal and secure life [4].…”

Ictal analgesia in temporal lobe epilepsy – The mechanism of seizure-related burns

“…About 17% of epilepsy patients suffer burns or scalding [6] and 1-4% of hospital admissions for burns are seizure-related [7][8][9][10].…”