Lisa Langenbruch1, Carolin Rickert2, Georg Gosheger3, Dominik Schorn4, Benedikt Schliemann5, Tobias Brix6, Christian E Elger7, Sven G Meuth8, Stjepana Kovac9. 1. Department of Neurology, University of Münster, Münster, Germany. Electronic address: lisamarie.langenbruch@ukmuenster.de. 2. Department of General Orthopedics and Tumor Orthopedics, University of Münster, Münster, Germany. Electronic address: carolin.rickert@ukmuenster.de. 3. Department of General Orthopedics and Tumor Orthopedics, University of Münster, Münster, Germany. Electronic address: georg.gosheger@ukmuenster.de. 4. Department of General Orthopedics and Tumor Orthopedics, University of Münster, Münster, Germany. Electronic address: dominik.schorn@ukmuenster.de. 5. Department of Trauma, Hand and Reconstructive Surgery, University of Münster, Münster, Germany. Electronic address: benedikt.schliemann@ukmuenster.de. 6. Institute of Medical Informatics, University of Münster, Münster, Germany. Electronic address: tobias.brix@ukmuenster.de. 7. Department of Neurology, University of Münster, Münster, Germany; Kompetenzzentrum für Epileptologie, Beta Neurologie, Bonn, Germany. Electronic address: christian.elger@betaklinik.de. 8. Department of Neurology, University of Münster, Münster, Germany. Electronic address: sven.meuth@ukmuenster.de. 9. Department of Neurology, University of Münster, Münster, Germany. Electronic address: Stjepana.Kovac@ukmuenster.de.
Abstract
PURPOSE: We aimed to identify clinical characteristics of patients with shoulder dislocations caused by an epileptic seizure. METHODS: In our retrospective analysis, we identified 15 patients, recorded over an 8-year period, who were diagnosed with shoulder dislocations in the setting of a bilateral tonic-clonic seizure. RESULTS: Patients were almost exclusively male (13/15) and drug-naïve patients suffering their first or second seizure (14/15). Epilepsy was diagnosed in five of these 14 patients after further diagnostic tests, four patients were diagnosed with a provoked or acute symptomatic seizure and five patients with an unprovoked seizure. Treatment with anticonvulsant drugs (AED) was initiated in 10/15 patients after the first seizure, without recommendation for tapering, although long-term treatment was retrospectively judged to be appropriate for only four of those cases. Posterior dislocations - usually rare - were seen in 12/15 patients and often required complex orthopedic interventions. CONCLUSIONS: We conclude that in particular posterior shoulder dislocations are often caused by a first seizure and should always raise the suspicion of an epileptic seizure even in the absence of a clear history. AED treatment likely has a protective effect against this type of injury, even if seizure-freedom is not achieved.
PURPOSE: We aimed to identify clinical characteristics of patients with shoulder dislocations caused by an epileptic seizure. METHODS: In our retrospective analysis, we identified 15 patients, recorded over an 8-year period, who were diagnosed with shoulder dislocations in the setting of a bilateral tonic-clonic seizure. RESULTS:Patients were almost exclusively male (13/15) and drug-naïve patients suffering their first or second seizure (14/15). Epilepsy was diagnosed in five of these 14 patients after further diagnostic tests, four patients were diagnosed with a provoked or acute symptomatic seizure and five patients with an unprovoked seizure. Treatment with anticonvulsant drugs (AED) was initiated in 10/15 patients after the first seizure, without recommendation for tapering, although long-term treatment was retrospectively judged to be appropriate for only four of those cases. Posterior dislocations - usually rare - were seen in 12/15 patients and often required complex orthopedic interventions. CONCLUSIONS: We conclude that in particular posterior shoulder dislocations are often caused by a first seizure and should always raise the suspicion of an epileptic seizure even in the absence of a clear history. AED treatment likely has a protective effect against this type of injury, even if seizure-freedom is not achieved.
Authors: Winston W Yen; Geoffrey W Cloud; J Roscoe Wasserburg; Gregory S Penny; Louis M Day; Scott C Pascal; Steven M Andelman; Arvind G Von Keudell; Nishant Suneja Journal: Arch Bone Jt Surg Date: 2022-04
Authors: Winston W Yen; Nouraiz Falik; Lara G Passfall; Oscar Krol; Thomas E Sanchez; Gregory S Penny; Bradley C Wham; Nishant Suneja Journal: J Orthop Date: 2021-05-07