Abstract found on Wiley Online Library
Objectives: Patients with epilepsy have a high risk of accidents and injuries, resulting in minimized physical activity and social withdrawal. Therefore, we surveyed the types of injuries that adult and paediatric patients with epilepsy may endure, the factors that may increase the risk of injuries, the clinical outcomes, and the limitations the patients may encounter because of traumas.
Methods: In this cohort study, adult and paediatric patients diagnosed with epilepsy (age?7?years) and a close family member (parents/guardian) attending the outpatient epilepsy clinics at King Fahd Medical City (Riyadh, Saudi Arabia) were interviewed by neurologists. They reviewed the patients’ medical records and administered a structured questionnaire to identify and compare several variables, including injury frequency versus seizure type and seizure frequency, number of antiseizure medications used, medication compliance, and work and social limitations.
Results: The study enrolled 200 patients. No association existed between the cause and frequency of seizures (P=0.3). However, genetic generalised epilepsy was encountered more in injured patients (P=0.02). Furthermore, the injuries were more frequent in patients with monthly convulsions (P=0.018). Generalised tonic-clonic seizures and focal to bilateral tonic-clonic seizures were the most frequent causes of injuries, mainly soft-tissue injuries sustained at home. After studying the relation between injury and the number of anti-seizure medications, the association between these variables was significant (P=0.0036). The patients on polytherapy were more likely than those on monotherapy to have an injury. However, the patients on polytherapy experienced more daily and monthly seizures (P=0.04), which could be the reason for the increased propensity to have injuries in this group.
Significance: Soft-tissue injuries and head traumas were the most common injuries. Moreover, most injuries occurred at home, and the injury frequency increased as the duration of epilepsy increased. Furthermore, we found a significantly increased risk of injury among patients with generalized tonic-clonic seizures and focal to bilateral tonic-clonic seizures. Further, polytherapy was associated with a higher prevalence of injuries than monotherapy. Finally, we found that social withdrawal was common among patients with frequent convulsions and traumas.