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

Objective: The goal of this study was to assess the characteristics and risk factors for injuries caused by seizures in older persons.

Methods: All 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.

Results: Over 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).

Conclusion: These findings suggest that falls rather than seizures per se are the dominant influence in the pathogenesis of fractures in older patients with epilepsy.