Injury and death as a result of seizures

The literature contains little information regarding the incidence of injury or death in the general population caused by seizures. We prospectively surveyed all patient visits to the four emergency departments serving adults in the Halifax-Dartmouth metropolitan area (adult population 260,935) from September 1, 1990 to August 31, 1991 to identify patients treated as a result of a seizure. The medical examiner's records were also surveyed for deaths related to seizures. We identified 560 patient visits precipitated by seizures of all types and etiologies except those secondary to acute trauma. Injuries or deaths occurred during 84 of 560 seizures (15%). Sixty-three patients incurred 89 injuries during 77 seizures (some patients had more than one injury, and some patients had injuries on more than one occasion). The incidence of seizures resulting in injury was 29.5 in 100,000 population. The most common injuries were head contusions and head lacerations. Most injuries were minor and required little or no treatment. Deaths occurred during seven seizures (1.2%). The incidence of death as a complication of seizures was 2.68 in 100,000 population. Deaths were not restricted to patients with epilepsy. We conclude that the incidence of seizures causing injury or death in the general population was 32.2 in 100,000 population and that 15% of seizures brought to medical attention resulted in injury or death. Most injuries were minor but seven patients died during seizures, indicating that seizures remain a life-threatening event.