[Nocturnal spinal fracture--first manifestation of epilepsy]

A 54-year-old patient suffered overnight a double thoracic burst-fracture. One week later during the investigation for a metabolic or endocrinological cause, a witnessed seizure led to an unstable fracture of the humerus and the scapula. The neurological work-up revealed a cerebral astrocytoma as the epileptogenic focus. Forces generated during a tonic-clonic seizure can result in axial skeletal trauma, including thoracic and lumbar burst fractures. Vertebral fractures unrelated to an exogenous trauma are therefore always suspicious of an underlying epileptic disease.