The Analysis of Generalized Tonic Clonic Seizures Associated Injuries in Emergency Department

Abstract

Objectives: Persons with epilepsy are believed to be at greater risk of incurring accidental injury than those without seizures. During generalized seizures the individual is unable to utilize protective reflexes during falls and may consequently suffer head, orthopedic, or soft tissue injury. Our aim is to evaluate the spectrum of trauma in epilepsy patients presenting to our emergency department as a result of generalized tonic-clonic seizure (GTCS).
Methods: We retrospectively reviewed patient records collected between January 2004 and December 2007 at the Emergency Department of Dicle University Medical School. All patients aged 15 years or more with epilepsy and trauma due to generalized tonic clonic seizures were included in the study. Records were analyzed for age, gender, type of injury, sufficiency of anti-epileptic medication, and mortality.
Results: The average age of the 51 patients included in the study was 26.02±9.86 years, range 15-52 years. Thirty-three patients (64.7%) were male; the male female ratio was 1.83. Soft tissue injuries were the most common injury (26 instances). Head trauma, cuts, dental and tongue injuries were less common. Blood levels of anti-epileptic medication were in the therapeutic range in 9 (17.6%) patients, while 42 (82.4%) had sub therapeutic levels for effective treatment. Four (7.8%) of the patients died. The trauma in 2 mortalities involved burns; remaining deaths were associated with submersion injury and fall (subarachnoidal hemorrhage).
Conclusions: There was no significant association between sub therapeutic levels of anti-epileptic medication and mortality.