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Pathological fractures in epilepsy.

Raj D Sheth1, Barry E Gidal, Bruce P Hermann

  • 1Department of Neurology, University of Wisconsin-Madison, Madison, WI 53792-5132, USA. sheth@neurology.wisc.edu

Epilepsy & Behavior : E&B
|September 15, 2006
PubMed
Summary
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Patients with epilepsy experience fractures at higher rates than the general population. This study reveals that pathological fractures significantly contribute to fracture risk across all ages, not just in older adults.

Area of Science:

  • Neurology
  • Orthopedics
  • Epidemiology

Background:

  • Fracture incidence is significantly elevated in individuals with epilepsy compared to the general population.
  • The specific roles of gender and age in epilepsy-related fractures require further elucidation.

Purpose of the Study:

  • To investigate the fracture rates and types in a cohort of patients with epilepsy over a 7-year period.
  • To determine the influence of age and fracture type (pathological vs. traumatic/seizure-related) in patients with epilepsy.

Main Methods:

  • Retrospective analysis of 750 patients with epilepsy who sustained fractures over 7 years at a single healthcare center.
  • Categorization of fractures into pathological and traumatic/seizure-related types.
  • Age-stratified analysis, with a specific focus on patients over 60 years old.

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Main Results:

  • Overall, 39% of fractures were pathological and 61% were traumatic/seizure-related.
  • In patients over 60 years, pathological fractures constituted 71% of all fractures (P<0.02).
  • Fractures in epilepsy exhibit bimodal peaks in the fifth and eighth decades, with pathological fractures being a notable factor across all age groups.

Conclusions:

  • Epilepsy and/or its treatment are significant factors in fracture pathogenesis.
  • Pathological fractures are a considerable contributor to overall fracture risk in epilepsy patients, even in younger individuals.
  • Epilepsy may exacerbate age-related osteoporosis, leading to increased fracture susceptibility.