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. 2016 Sep;60(3):252-257.

Multiple seizure-induced thoracic vertebral compression fractures: a case report

Peter Stilwell  1 , Katherine Harman  1 , William Hsu  2 , Brian Seaman  3
Affiliations

Multiple seizure-induced thoracic vertebral compression fractures: a case report

Peter Stilwell et al. J Can Chiropr Assoc. 2016 Sep.

Abstract
in English, French

Background: Musculoskeletal injuries stemming from forceful muscular contractions during seizures have been documented in the literature. Reports of multiple seizure-induced spinal fractures, in the absence of external trauma and without risk factors for fracture, are rare.

Case presentation: A 28-year-old male, newly diagnosed with epilepsy, presented to a chiropractic clinic with the complaint of mid-thoracic pain beginning after a tonic-clonic seizure with no associated external trauma. Radiographs revealed the impression of five new vertebral compression fractures from T4 to T8.

Discussion: This report highlights the importance of a complete history and examination of patients with a history of tonic-clonic seizures and back pain, especially when considering spinal adjustments.

Summary: This case report presents an argument that a tonic-clonic seizure, in the absence of external trauma or significant risk factors for fracture, resulted in multiple vertebral compression fractures.

Contexte: Des études sur les blessures musculosquelettiques résultant de contractions musculaires forcées pendant les crises épileptiques ont déjà été publiées dans les revues scientifiques. Les rapports de fractures vertébrales multiples causées par des crises épileptiques, en l’absence de traumatismes externes et sans facteurs de risque de fracture, sont rares.

Exposé de cas: Un homme de 28 ans, qui a reçu un diagnostic récent d’épilepsie, s’est présenté à une clinique de chiropratique se plaignant d’une douleur mi-dorsale débutant après une crise de grand mal sans traumatisme externe associé. Les radiographies révèlent l’impression de cinq nouvelles fractures vertébrales par compression de T4 à T8.

Discussion: Ce rapport souligne l’importance d’un historique complet et de l’examen des patients ayant des antécédents d’une crise de grand mal et de douleurs dorsales, en particulier si l’on envisage des ajustements vertébraux.

Résumé: Ce rapport de cas présente l’argument qu’une crise de grand mal, en l’absence de traumatismes externes ou de facteurs de risque significatifs pour fracture, a donné lieu à de multiples fractures vertébrales par compression.

Keywords: back pain; chiropractic; compression fracture; seizure; spinal manipulation; thoracic.

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Figures

Figure 1a.
Figure 1a.
AP and lateral views of the thoracic spine demonstrated moderate anterior wedged deformity of T7 vertebral body with approximately 50% loss of vertebral body height.
Figure 1b.
Figure 1b.
Close-up lateral view of the upper thoracic spine revealed the convex deformity of the posterior vertebral body of T7 as well as the accentuated superior endplate concavities of the T6 and T8 (white arrows). Zones of impacted trabeculae (arrowheads) were evident subjacent to the T6 and T7 superior endplates.
Figure 2.
Figure 2.
Swimmer’s view revealed the accentuated superior endplate concavities at T4, T5 and T6 when compared to the T3 superior endplate.
See this image and copyright information in PMC

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