Risk of aspiration pneumonia after an epileptic seizure: a retrospective analysis of 1634 adult patients.
We reviewed the incidence of aspiration pneumonia secondary to seizures in three populations of patients with chronic epilepsy: 733 outpatients seen in an Epilepsy Foundation clinic; 806 adult patients admitted to two university video telemetry units; and 95 institutionalized, profoundly retarded adult patients with chronic epilepsy. Two of the 733 adults who had seizures in the outpatient setting and 2 of the 806 patients who had one or more epileptic seizures in the telemetry units developed aspiration pneumonia. In the 95 institutionalized patients, there were 17 instances of aspiration pneumonia after a generalized seizure and 32 instances of aspiration unrelated to seizures over a 12-month period. Our findings suggest that aspiration pneumonia is not a common complication of seizures in otherwise healthy adults. The increased incidence of aspiration in developmentally delayed individuals seems to derive from a combination of factors. Increased oral secretions, impaired swallowing mechanisms, and difficulty in attaining adequate patient positioning significantly increased the risk of aspiration.
DeToledo
John C
JC
Department of Neurology, University of Miami, Miami, FL, USA. jdetoled@med.miami.edu
Lowe
Merredith R
MR
Gonzalez
Jose
J
Haddad
Helena
H
D000328:Adult; D004827:Epilepsy / Q000150:complications*; D006801:Humans; D011015:Pneumonia, Aspiration / Q000453:epidemiology / Q000209:etiology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013686:Telemetry; D014741:Video Recording / Q000379:methods