Simultaneous Bilateral Anterior Shoulder Dislocation Following Epileptic Seizure in a Middle-Aged Male: A Rare Case...

Bilateral anterior shoulder dislocation (BASD) is an exceptionally rare clinical entity, especially when associated with epileptic seizures. Seizure-related shoulder dislocations are predominantly posterior due to the forceful contraction of internal rotator muscles; anterior dislocations following seizures are unusual and typically result from secondary trauma during a convulsive collapse.

This case report describes a 32-year-old male with a known history of epilepsy who presented with simultaneous BASDs immediately after a generalized tonic-clonic seizure. Clinical examination revealed the classic signs of anterior dislocation, including loss of normal shoulder contour, squared-off appearance (Epaulet sign), and humeral heads palpable anteriorly in the deltopectoral grooves. Radiographs confirmed bilateral subcoracoid anterior dislocations without associated fractures. The patient was successfully treated with closed reduction under intravenous sedation using the Kocher's maneuver, followed by immobilization and structured rehabilitation. At 1 year of final follow-up, functional outcomes were excellent, with full pain-free range of shoulder motion and no instability episodes.

For uncomplicated BASD cases, closed reduction with prompt immobilization and physiotherapy remains the mainstay of management. Control of the underlying seizure disorder is crucial to prevent recurrence. This report adds to the limited literature on this rare presentation, emphasizing diagnostic challenges, management strategies, and outcomes associated with BASD in the context of epilepsy.