title: [Nocturnal spinal fracture--first manifestation of epilepsy].
abstract: A 54-year-old patient suffered overnight a double thoracic burst-fracture. One week later during the investigation for a metabolic or endocrinological cause, a witnessed seizure led to an unstable fracture of the humerus and the scapula. The neurological work-up revealed a cerebral astrocytoma as the epileptogenic focus. Forces generated during a tonic-clonic seizure can result in axial skeletal trauma, including thoracic and lumbar burst fractures. Vertebral fractures unrelated to an exogenous trauma are therefore always suspicious of an underlying epileptic disease.
authors.affiliation: Neurologische Klinik, Ruprecht-Karls-Universität Heidelberg.
authors.forename: T A
authors.initials: TA
authors.lastname: Rupprecht
authors.forename: P D
authors.initials: PD
authors.lastname: Schellinger
authors.forename: A
authors.initials: A
authors.lastname: Mohr
authors.forename: H M
authors.initials: HM
authors.lastname: Meinck
mesh_terms: D001254:Astrocytoma / Q000175:diagnosis; D001932:Brain Neoplasms / Q000175:diagnosis; D002940:Circadian Rhythm; D003937:Diagnosis, Differential; D004829:Epilepsy, Generalized / Q000175:diagnosis*; D050723:Fractures, Bone / Q000175:diagnosis / Q000209:etiology; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D006810:Humeral Fractures; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012540:Scapula / Q000293:injuries; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000293:injuries*; D014057:Tomography, X-Ray Computed