Retrospective study of seizure-related injuries in older people: A 10-year observation

ObjectiveThe goal of this study was to assess the characteristics and risk factors for injuries caused by seizures in older persons.MethodsAll patients aged 65 years or older having injuries secondary to seizures between July 1, 1999, and June 30, 2009, were identified through the diagnostic coding system.ResultsOver the assessment period, a total of 615 patient episodes of seizures were recorded. Nineteen seizure-related injury events occurred in 18 persons with a total of 31 injuries. In the control group, 34 non-seizure-related injuries that were not seizure related occurred in 27 patients (28 patient episodes) (P = 0.21). The majority of injuries in both groups resulted from falls. Fifty-three percent of seizures occurred indoors, and the majority of seizures were generalized tonic–clonic seizures. Of the seizure-related injury events, 8 (42%) were single injuries, and 11 (61%) were multiple injuries. The predominant injuries were soft tissue injuries (55%), fractures (35%), and head injuries (10%). The groups did not differ significantly with respect to fractures (P = 0.06) or soft tissue injuries with lacerations (P = 0.41), or injury severity (P = 0.16), or treatment of osteoporosis (P = 0.56).ConclusionThese findings suggest that falls rather than seizures per se are the dominant influence in the pathogenesis of fractures in older patients with epilepsy.

Research Highlights
► The incidence of provoked and unprovoked seizures is known to increase with advancing age.
► This is the first study to assess the risk of injury in a hospital based cohort of elderly persons with epilepsy.
► This represents the significant end of the spectrum for seizure disorders in the elderly and this injury rate was low.
► Our findings suggest that falls rather than seizures per se are the dominant influence in the pathogenesis of fractures in older patients with epilepsy.