Life-long history of injuries related to seizures

Neufeld, Miriam Y.; Vishne, Tali; Chistik, Vladimir; Korczyn, Amos D.

doi:10.1016/s0920-1211(98)00105-3

Cited by 110 publications

(107 citation statements)

References 8 publications

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“…5 Unintentional poisonings are a significant cause of deaths worldwide 17 in children and young adults and were the third leading cause of injury hospitalizations in the United States in 2000, 5 with an incidence of 60 medically attended injuries per 10 000 personyears in ,25-year-olds and a total lifetime cost of $583 million. 5 Previous studies, mainly in adults, suggest epilepsy is associated with a higher risk of injuries, 18,19 thought to be caused by the seizures themselves, and adverse effects of antiepileptic drugs (AEDs). 20,21 Earlier studies on epilepsy and injuries may have overestimated injury risk by using populations with more severe epilepsy, such as institutionalized adults 22 or those in epilepsy clinics.…”

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confidence: 99%

“…18 Questionnaire-based studies ascertaining injury retrospectively are subject to recall bias, with caregivers or relatives more likely to recall an injury if the participant has epilepsy. 19 Few studies have measured the rate of injuries prospectively in the general population. [23][24][25] A prospective European study in .5-year-olds found no greater injury risk associated with epilepsy, 25 whereas a US study concluded that the risk of serious injuries in epilepsy is minor, 23 and a UK study using the Clinical Practice Research Datalink (CPRD) reported the risk of fracture in people with epilepsy to be twice that of those without epilepsy.…”

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Injury Among Children and Young Adults With Epilepsy

et al. 2014

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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

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Injury Among Children and Young Adults With Epilepsy

et al. 2014

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“…Several studies show that the risk of accidents involving patients with epilepsy is higher than the risk in the general population. The most common accident types are falls, drowning, chocking and burns [2][3][4][5][6][7][8][9] . childhood is an accident-prone age, and epilepsy might increase the likelihood of accidents during childhood.…”

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Seizure related accidents and injuries in childhood

Buffo

Guerreiro

Tai

et al. 2008

Arq. Neuro-Psiquiatr.

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-Several studies show that the risk of accidents involving patients with epilepsy is much higher compared to the general population. The objective of this study was to identify the frequency and type of seizure related injuries in children diagnosed with epilepsy. In addition we also assessed possible risk factors associated with this seizure related accidents in childhood. This study was conducted at the pediatric epilepsy clinic of UNIcAmp, from January 2005 to August 2006. We evaluated 100 consecutive children with epilepsy. parents were interviewed by one of the authors using a structured questionnaire that included questions about seizure related accidents and related injuries. Forty-four patients reported seizure related accidents. Eighteen patients needed medical assistance at an emergency room due the severity of their seizure related accident. Forty patients reported having a seizure related accident prevented by a bystander. Another 14 patients reported avoiding a seizure related accident by luck alone. contusions and lacerations were the most common type of lesion associated with seizures. patients with symptomatic/probable symptomatic epilepsy and those using higher numbers of anti-epileptic drugs (AEDs) were at greater risk for seizure related accidents (p<0.05). We conclude that patients with symptomatic/probable symptomatic epilepsy and on multiple AEDs are at increased risk of seizure related accidents. parents and caretakers should be even more cautious about risk of injury in such patients.KEy WorDS: children, epilepsy, accident. acidentes e lesões associados às crises epilépticas na infânciaResumo -Vários estudos mostram que o risco de acidentes envolvendo pacientes com epilepsia é muito maior do que na população geral. o objetivo desse estudo foi identificar a freqüência e tipo de acidentes relacionados a crises epilépticas em crianças com diagnóstico de epilepsia. Além disso, também avaliamos os fatores de risco associados às crises epilépticas na infância. Esse estudo foi realizado em nosso ambulatorio de epilepsia infantil da UNIcAmp, no período de janeiro de 2005 a agosto de 2006. Avaliamos 100 pacientes consecutivos. os pacientes foram entrevistados por um dos autores, utilizando-se um questionário sobre acidentes e lesões associadas às crises epilépticas. Quarenta e quatro pacientes apresentaram acidentes relacionados às crises epilépticas. Dezoito pacientes precisaram assistencia médica em pronto socorro devido à gravidade das lesões. Quarenta pacientes relataram que um acidente foi evitado devido ao socorro de uma outra pessoa. outros 14 pacientes relataram que um acidente foi evitado apenas por sorte. contusões e lacerações foram os tipos de lesão mais comuns. pacientes com epilepsia sintomática ou provavelmente sintomática, e pacientes em uso de politerapia apresentaram maior risco de acidentes relacionados às crises epilepticas (p<0.05). concluímos que pacientes com epilepsia sintomática/provavelmente sintomática em uso de politerapia apresentam risco de acidentes elevado....

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“…Generalized tonic-clonic (GTC) seizures (especially generalized-onset) seem to be associated with a higher injury rate than other seizure types (1)(2)(3), although childhood absence seizures may increase the risk of injury (4). In addition, medication toxicity may produce ataxia that may lead to an increased risk of falls.…”

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Sudden Unexplained Death and Injury in Epilepsy

Ficker¹

2000

Epilepsia

140

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Summary:Seizures may be associated with risk of injury or death. Injuries are common in patients with epilepsy, with up to 30% of patients reporting injuries, most commonly blunt trauma and lacerations. Seizures associated with falls increase the risk of injury, but any seizure that is associated with alteration in consciousness may cause injury. Patients with seizures may injure others, especially by causing motor vehicle accidents. Each state has restrictions on driving, requiring seizurefree intervals that range from 3 to 18 months. Mortality is increased in patients with epilepsy. The standardized mortality ratio is increased two to three times in epilepsy cohorts. Sudden unexplained death in epilepsy (SUDEP) is responsible for 2% to 17% of all deaths in patients with epilepsy, depending on the cohort studied. Population-based studies of SUDEP show a lower overall SUDEP rate compared with clinical trials or epilepsy referral center cohorts. Overall, the risk of sudden death is increased in the epilepsy population by 24 times compared with the general population. Risk factors for SUDEP may include poorly controlled seizures, early onset of epilepsy, and generalized tonic-clonic seizures. The pathophysiology of SU-DEP is unknown, but animal data suggest apnea may be the initial factor that results in sudden death.

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Life-long history of injuries related to seizures

Cited by 110 publications

References 8 publications

Injury Among Children and Young Adults With Epilepsy

Injury Among Children and Young Adults With Epilepsy

Seizure related accidents and injuries in childhood

Sudden Unexplained Death and Injury in Epilepsy

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