Simultaneous bilateral fractures of the hip following a grand mal seizure. An unusual complication

Abstract

Pathological fractures as a consequence of convulsive seizures without direct trauma occur in 0.3% of cases. Some lesions such as bilateral posterior dislocation of the shoulder, fracture-dislocation of the shoulder or fracture and/or dislocation of the hip strongly suggest a seizure as the aetiology. We report on a patient with simultaneous central dislocation of one hip with fracture of the contralateral femoral neck provoked by spontaneous seizures. Unrecognized associated injuries following a convulsion may result in long-term functional disability and legal consequences.

A missed orthopaedic injury following a seizure: a case report

“…The literature contains descriptions of fractures and dislocations of the shoulder [1-4], femur [5], acetabulum [6] and compression [7] or burst [8] fractures of the vertebrae following a seizure. The incidence of orthopaedic injuries that are missed following a seizure is unknown.…”

Non-traumatic fracture of the femur in a infant with recurrent epileptic seizures: case report

“…4 The pathological fractures without direct trauma occur in 0.3% of cases of convulsive seizure. 5 They may also be related or not to the use of antiepileptic drugs that act as co-factors for bone demineralization. 6,7 The infant in question did not present with a history of trauma, falls or battered-child syndrome, but she did use three antiepileptic drugs: phenobarbital, carbamazepine and clonazepam.…”

Fratura simultânea bilateral do colo do fêmur

“…Numa avaliação dos pacientes de Rochester e Minnesota, no período de 1928 a 1982, ocorreram 1701 fraturas do fêmur proximal, das quais apenas uma era bilateral. Fraturas patológicas como conseqüência de um choque convulsivante ocorrem em 0,3% dos casos (16) .…”