Unorthodox Use of Point-of-care Ultrasound to Evaluate Seizures

Abstract

It can be difficult to distinguish between syncope and seizure. Some stigmata of seizure include post-ictal period, tongue-biting or incontinence. A less common finding after a seizure is a posterior shoulder dislocation. Posterior shoulder dislocation is commonly missed and may be the only finding after a seizure, thus aiding in diagnosis. In this case report, we discuss the incidence of posterior shoulder dislocations and their utility in differentiating syncope from seizure, as well as the ability to diagnose and evaluate for proper reduction of posterior shoulder dislocations using ultrasound.

Keywords: point of care ultrasound; posterior shoulder dislocation; seizure.

Figure 1. Posterior shoulder dislocation

A low-frequency curvilinear transducer is placed on the patient’s posterolateral right shoulder. The humeral head (☆) is posteriorly displaced from the glenoid (△).

Figure 2. Reduced dislocation of the right shoulder

A low-frequency curvilinear transducer is placed on the patient’s posterolateral right shoulder. The humeral head (☆) is aligned the glenoid (△).