Bilateral Scapular Fractures Occurring as a Result of a First-Time Seizure

Area of Science:

• Neurology
• Orthopedics
• Trauma Medicine

Background:

• Generalized tonic-clonic seizures (GTCS) are associated with significant risks of physical injury.
• Injuries result from intense muscular contractions and loss of consciousness during seizures.
• Common injuries include soft tissue contusions, tongue/dental trauma, and facial lacerations.

Observation:

• A case of bilateral scapular fractures is presented in a 32-year-old male.
• The patient experienced shoulder and back pain and limited arm movement post-seizure.
• This occurred after an apparent first-time generalized tonic-clonic seizure without significant witnessed trauma.

Findings:

• Bilateral scapular fractures are an uncommon but potential orthopedic complication of GTCS.
• The injury mechanism involves forceful muscular contractions or traumatic falls during seizures.
• Unexplained scapular fractures in patients with sudden loss of consciousness warrant investigation for seizures.

Implications:

• Clinicians should consider GTCS as a potential etiology for bilateral scapular fractures, especially in the absence of clear trauma.
• This emphasizes the need for thorough neurological assessment in patients with unexplained orthopedic injuries.
• Recognizing seizure-induced injuries can lead to timely diagnosis and management of underlying epilepsy.