Recurrent seizure-related injuries in people with epilepsy at a tertiary epilepsy center: A 2-year longitudinal study

Though seizure-related injuries (SRIs) among people with epilepsy (PWE) have recently gained much attention in the literature, most studies are retrospective and data are gathered indirectly through questionnaires or medical record documentation. We investigated SRIs and their associated risks in PWE attending a tertiary care center with direct and systematic inquiries during routine clinic follow-up visits over a 2-year period (N = 306). Past SRIs occurred in 54% of all patients, and 24% experienced recurrent SRIs during the study period. On multiple regression analyses, past SRI was associated with tonic–clonic seizures (TCSs) (3.2, 95% CI = 1.7–5.8) and cognitive handicap (4.3, 95% CI 1.5–16.1), and recurrent SRI was associated with TCSs (3.5, 95% CI = 1.6–7.9). Most recurrent SRIs (72%) involved head injury. SRIs are common when assessed systematically in a tertiary care setting, and TCSs represent a risk factor for recurrent SRIs. The potential clinical impact of recurrent SRIs on PWE requires further study.

Research Highlights
► Recurrent seizure-related injuries are common among people with epilepsy receiving care in a tertiary epilepsy center.
► Systematically screening for recurrent seizure-related injuries may improve data collection.
► Mild head injuries are the most common seizure-related injuries encountered.
► A history of predominantly tonic clonic seizures is a major risk factor for both past and recurrent seizure-related injuries.
► Though baseline cognitive dysfunction is a risk for past seizure-related injury, it is not associated with recurrent injuries.