Seizure-related injuries in newly diagnosed childhood epilepsy

Abstract

This study sought to evaluate seizure-related injuries in children under age 18 years with newly diagnosed epilepsy presenting at the Department of Pediatrics, Tuen Mun Hospital, in 2002-2003. All children were interviewed before January 2005. Children with seizure-related injuries were compared with those without injuries for identification of risk factors. One hundred and twenty-two children were surveyed. No patient died during a seizure. Eleven (9%) children manifested seizure-related injuries. Injury occurred at a mean age of 11.6 years, and epilepsy was diagnosed at a mean age of 13.8 years, in those with seizure-induced injuries. Injury occurred at first seizure presentation or upon diagnosis of epilepsy in 72.7% patients. Ten (90.9%) children were not receiving antiepileptic drugs at their time of injury. The mean age of seizure onset was 10.7 years in patients with injuries, and 6.7 years in control subjects (P = 0.007). Seizures resulting in injuries were generalized tonic-clonic in 72.7% (P = 0.045; odds ratio, 3.77; 95% confidence interval, 0.95-14.98). Idiopathic etiology was evident in 54.5%, and normal neurodevelopmental status in 72.7%, of patients with injuries. Age of seizure onset was the only independent variable retained after multivariate analysis. Soft-tissue and dental injuries comprised 91.7% and 75%, respectively, of injuries occurring at home. The risk of seizure-related injuries was substantial, especially before epilepsy was diagnosed, but most of these injuries were minor. These unique data could help in parental counseling.