Injuries from seizures are a serious, persistent problem in childhood onset epilepsy: a population-based study
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Published on: June 21, 2019
Carol Camfield1, Peter Camfield1
1Department of Pediatrics, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada.
Insights
Serious injuries from seizures are common in childhood-onset epilepsy, with 11% experiencing them over 24 years. Better seizure control is key to preventing these injuries.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Injury Prevention
Background:
- Childhood-onset epilepsy affects numerous individuals, posing risks beyond seizures.
- Injuries sustained during seizures can have significant health implications.
Purpose of the Study:
- To document the frequency, types, and risk factors of seizure-related injuries in childhood-onset epilepsy.
- To identify patterns and potential preventative measures for these injuries.
Main Methods:
- A population-based cohort of patients with childhood-onset epilepsy (excluding absence epilepsy) was studied.
- Patients and parents reported serious injuries requiring urgent medical or dental care over an average follow-up of 23.9 years.
Main Results:
- 11% of 472 patients experienced at least one serious injury (81 total injuries) over ~24 years.
- Common injuries included lacerations, fractures, broken teeth, and concussions; "other" included drowning and dislocations.
- Injuries occurred across all epilepsy types, particularly in symptomatic generalized and intractable epilepsy, often years after diagnosis.
Conclusions:
- Approximately 1 in 10 patients with childhood-onset epilepsy suffer serious seizure-related injuries.
- Most injuries occur long after initial diagnosis and are linked to seizure frequency.
- Improved seizure control is the primary strategy for injury prevention.
Purpose:
Document the frequency, types and risk factors for injuries caused by seizures for people with childhood onset epilepsy.
Method:
We contacted patients with all types of epilepsy except childhood absence from the Nova Scotia Childhood Epilepsy population-based cohort. Seizure onset was between 1977 and 1985. Patients and parents were asked about serious injuries resulting from a seizure, defined as severe enough for an urgent physician or dentist visit.
Results:
Of 595 eligible patients, we contacted 472 (79%). During an average follow up of 23.9 ± 8 years, 52 (11%) experienced ≥1 serious injury for a total of 81 injuries. Of all injuries, 24 (30%) were lacerations requiring sutures, 15 (19%) fractures, 11 (14%) broken teeth, 8 (10%) concussions, 4 (5%) burns, and 20 (25%) other. "Other" included 1 fatal drowning, 2 near-drownings, 3 shoulder dislocations and 1 severe eye injury. Four injuries occurred with the first seizure; all others after a long gap from seizure onset (range 1.5-30 years). Injuries occurred in all epilepsy syndromes, most commonly with symptomatic generalized epilepsy (17% vs. 11% p = 0.03) and intractable epilepsy (28% vs. 8% p<0.0001). Most injuries occurred during normal daily activities and were judged not to be easily preventable.
Conclusions:
During ∼24 years of follow up 1 out of 10 patients with childhood onset epilepsy had a serious injury as the result of a seizure. Most injuries occurred years after the initial diagnosis and were more common when seizures were more frequent. The only practical solution to injury prevention is better seizure control.
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