title: Injuries from seizures are a serious, persistent problem in childhood onset epilepsy: a population-based study.
abstract: OBJECTIVE
  Document the frequency, types and risk factors for injuries caused by seizures for people with childhood onset epilepsy.
  
  
  METHODS
  We contacted patients with all types of epilepsy except childhood absence from the Nova Scotia Childhood Epilepsy population-based cohort. Seizure onset was between 1977 and 1985. Patients and parents were asked about serious injuries resulting from a seizure, defined as severe enough for an urgent physician or dentist visit.
  
  
  RESULTS
  Of 595 eligible patients, we contacted 472 (79%). During an average follow up of 23.9 ± 8 years, 52 (11%) experienced ≥1 serious injury for a total of 81 injuries. Of all injuries, 24 (30%) were lacerations requiring sutures, 15 (19%) fractures, 11 (14%) broken teeth, 8 (10%) concussions, 4 (5%) burns, and 20 (25%) other. "Other" included 1 fatal drowning, 2 near-drownings, 3 shoulder dislocations and 1 severe eye injury. Four injuries occurred with the first seizure; all others after a long gap from seizure onset (range 1.5-30 years). Injuries occurred in all epilepsy syndromes, most commonly with symptomatic generalized epilepsy (17% vs. 11% p = 0.03) and intractable epilepsy (28% vs. 8% p<0.0001). Most injuries occurred during normal daily activities and were judged not to be easily preventable.
  
  
  CONCLUSIONS
  During ∼24 years of follow up 1 out of 10 patients with childhood onset epilepsy had a serious injury as the result of a seizure. Most injuries occurred years after the initial diagnosis and were more common when seizures were more frequent. The only practical solution to injury prevention is better seizure control.
authors.affiliation: Department of Pediatrics, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Camfield
authors.affiliation: Department of Pediatrics, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada. Electronic address: camfield@dal.ca.
authors.forename: Peter
authors.initials: P
authors.lastname: Camfield
mesh_terms: D000293:Adolescent; D000328:Adult; D001924:Brain Concussion / Q000209:etiology*; D001930:Brain Injuries / Q000209:etiology*; D002648:Child; D015331:Cohort Studies; D018672:Community Health Planning; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D008297:Male; D012640:Seizures / Q000150:complications*; D013997:Time Factors; D018677:Tooth Injuries / Q000209:etiology*; D055815:Young Adult
keywords: Accidents; Childhood; Epilepsy; Injury; Population-based