Injuries from seizures are a serious, persistent problem in childhood onset epilepsy: A population-based study
Introduction from Dr Markus Reuber, editor-in-chief of Seizure
Seizure 27 has published Injuries from seizures are a serious, persistent problem in childhood onset epilepsy: A population-based study
Epilepsy can be frightening to people having seizure and those observing seizures, especially if the seizures affect close family members. Worries about seizures themselves may be compounded by concerns about seizure-related injuries. Indeed many previous studies demonstrate that having epilepsy puts people at risk of physical harm, including serious injuries and death. The injury risk is not only increased because of seizures but also because of other brain dysfunctions related to the underlying cause of the epilepsy (such as a previous brain haemorrhage) and treatments administered to control seizures. Combined with the unpredictability of seizures the possibility of injuries is one of the main reasons why the independence and activities of many people with epilepsy are restricted.
The long-term follow-up study by Peter Camfield represents an important addition to our understanding of the risk of serious injuries associated with epilepsy (1). The study is based on responses of 472 patients originally diagnosed with epilepsy in childhood. After a mean follow up of 24 years, 11% of respondents reported at least one injury requiring treatment from a doctor or dentist. The total number of serious injuries was 81. The most common injuries were lacerations requiring sutures (30%) followed by fractures (19%) and broken teeth (14%). There was also one fatal drowning, two near-drownings, three shoulder dislocations and one severe eye injury. Most seizures occurred several years after seizure onset during normal daily activities and were not considered easily preventable.
Peter Camfield’s study confirms that having epilepsy can be dangerous. However, perhaps more importantly, it demonstrates that the absolute risk of serious injury associated with epilepsy is actually very low: only 81 serious injuries were reported in over 11,000 patient years observed. What is more, serious injuries were only reported by one in ten patients, suggesting that a history of seizure-related injuries is one of the most significant risk factors for a further injury. /p>
Obviously, the severity of some of the reported injuries, and the high frequency of serious injuries in some cases mean that the potential for seizure-related injuries has to be taken into account when patients, care givers and health professionals make decisions about which activities and how much independence may be safe for an individual person with epilepsy. However, these considerations raise the possibility that we may, collectively, have a tendency to be inappropriately overprotective and increase the disability associated with epilepsy in the process.
[1] Camfield P., Injuries from seizures are a serious, persistent problem in childhood onset epilepsy: a population-based study. Seizure 2015;27: 80–3.