Injuries and accidents in patients with epilepsy

There are certain situations in which there is a risk for people with epilepsy. In such situations, there is a possibility of complications and even death. Medical professionals clearly define the etiology of such cases and know how to prevent their occurrence. We are talking about changing the patient’s lifestyle, about the introduction of certain restrictions that will protect the patient. Despite the limited daily activity, the lifestyle of people with epilepsy should be active to the best of their condition. The presence of physical activity, breathing exercises depends on the individual characteristics of the organism.   

Typically, doctors impose restrictions on activities that can pose a threat to the patient’s life. The risk of complications arises if a person significantly increases daily activity, compared with the usual way of life. The driving of automobile transport by people with such a diagnosis is also questionable. The ability to drive depends on the general condition of the person and is discussed with the attending physician on an individual basis.

Epidemiology

Earlier, in the period from 1934 to 1974, a special study was carried out in the city of Rochester, United States of America. The reason for the study was the frequency of accidents among patients with epilepsy compared with healthy people. According to medical statistics, mortality among patients with epilepsy is 6.5%. According to the results for a healthy population, the mortality rate is 4.9%.  

It is known that from 5 to 10% of deaths are recorded during epileptic seizures. The risk of injury that does not result in death is also relatively high. We interviewed 340 patients who had at least one seizure per year. It was investigated that 30% of the interviewed patients suffered a serious trauma, which was associated with an epileptic seizure. Medical research was carried out in several emergency departments.

More than 250,000 people have been admitted to the medical institution . 0.38% of the total number, namely 557 patients, were admitted to the department when an epileptic seizure appeared. Of these, 14% developed an injury after the development of an attack. If this diagnosis is not treated in a timely manner and is not treated with appropriate therapy, epilepsy spreads. The risk of injury during the development of the disease is 5%.  

In the course of the study, it was found that 60 people have a neglected and difficult form of pathology. During the year, these patients were diagnosed with a total of up to 6900 seizures. At 2300 attacks, falls were noted. In 80 cases, patients were injured and injured. The risk of injury from epileptic seizures is 1.2% of cases per year. This indicator is increasing annually.

Certain types of damage and injury

The most common cause of death among patients with epilepsy is drowning. According to a medical study, 14 fatalities were observed over a ten-year period, of which 11 were due to drowning. Drowning deaths are more common among young people between the ages of 20 and 32. The oldest patient was 32 years old at the time of death. 

In addition, in the period from 1980 to 1986, pathological studies were carried out, which proved that in 17 cases, the result of drowning was a convulsive seizure with epilepsy. Often, seizure injury provokes head injury. Over the course of one year, 70 of the 300 respondents received a head injury as a result of a seizure. If seizures occurred in a medical institution, 57 out of 80 patients experience head injuries.

Risk factors

Among the main risk factors for getting grass during an epileptic seizure are the following characteristics:

• type of seizure;
• the frequency of the seizure;

Previous studies have shown that, in comparison with other patients, accidents most often occur with patients who have generalized tonic-clonic seizures. Lesions appear among those who have more than one attack per month.

Risk factors also include side effects after taking antiepileptic drugs. If more than three side effects are noticed after taking drugs, the frequency of injuries and trauma increases several times.

The following factors do not affect the incidence of injuries:

• patient gender;
• the age of the patient;

The research center cited statistics that among 62 patients who have a resistant form of epilepsy, lesions appear due to atonic seizures (13 patients out of 541 – 2.4%). 13 patients out of 782 (1.7%) suffer after tonic-clonic seizures. Complex partial seizures are called less dangerous. Only 34 cases out of 2805 were diagnosed with epileptic seizures. Simple and partial seizures do not lead to injury.

Epilepsy burns

According to medical statistics, most often burns occur with impaired consciousness. Risk factors include the frequency of seizures that have been transferred over the entire history of the disease. Basically, female patients are included in the group of patients who received burns. This is due to the fact that it is women who do household chores (cooking, cleaning).

Patients with impaired mental development are less prone to burns. Such people rarely lead an active lifestyle and engage in hazardous activities. The type of seizures and the patient’s age are not considered risk factors.

In general, burns are common among people with epilepsy. The study proved that 25 out of 244 people have moderate severity of burns, they needed special treatment and qualified medical care. Mostly people got burns at home. 10 cases occurred as a result of cooking, 5 – when taking a shower with hot water, 3 – when interacting with household heaters. The most serious injuries are from washing in the shower. In some cases, a skin graft was required.

The period of hospitalization in the burn center was up to 30 days. During the year, 15% of those with epilepsy received seizure burns.

How can the risk of such injury be prevented?

The risk of burns can be reduced by ensuring patient safety. For this, certain changes are introduced in the household. It is necessary to reduce the frequency of using hair dryers and irons. To avoid burns during bathing procedures, it is recommended to use special devices that measure the temperature of the water and stop the flow if the specified threshold is exceeded.

If there is a tendency to fall, a helmet must be worn. Some patients are strictly forbidden to be at a height, since if coordination is impaired, a fall and injury may occur.

Drowning

As stated earlier, drowning is considered the most common cause of death among people with epilepsy. According to the research center, the risk of drowning increases when it comes to children with epilepsy. In the period from 1974 to 1990, a study was conducted that proved that children and adolescents under 18 years of age had a high risk of drowning with epilepsy. The risk of drowning is 1,300 times higher than that of healthy children when it comes to bathing. In the pool, the risk increases 54 times.

Accidents occurred in the absence of adult supervision. Children under 5 years of age are as likely to drown as healthy children. Small children are in the water only under the supervision of their parents, regardless of the presence of the disease.

Head injury

Head injuries are the most common injuries in epilepsy. Such consequences of seizures do not pose a threat to the patient’s life and are rarely fatal. According to the data obtained, out of 70 patients with head injuries, 15 patients required specialized assistance, namely, suturing. 2 people were observed in the hospital for one day. The group of patients included only 2 patients who were delivered in serious condition. An intracranial hematoma was diagnosed, which required surgery, and a fracture of the skull bones.

In England, 27,935 injuries were diagnosed per year, of which 12,625 were from a fall. 765 patients were admitted with serious head injuries, 422 underwent bandaging and 340 underwent stitches. Only in one case was a skull fracture diagnosed. Two patients developed epidural and subdural bleeding.

Information was obtained on 58 cases of head injuries in patients who have a resistant form of epilepsy. In one case, a fracture of the skull bones was diagnosed, in 4 cases – brain contusion and one case with subdural hematoma. The latter case was seen in an elderly woman who suffered from complex partial seizures. The patient died during the surgery.

Injuries not directly related to seizures

Patients with epilepsy are at risk of falls that are not associated with an epileptic seizure. According to the study, among 200 patients, each patient suffered 40 seizures in a year. Only 35% of 320 suffered serious injuries and fractures. In patients who do not have epilepsy, the risk of fracture is one in 50 years. The study showed that a fracture is recorded every 14 years. Among 54 fractures in patients with epilepsy, only 14 cases of injury occurred during an attack.

Tips for preventing injury

The recommendations are intended for patients with any form of epilepsy. First of all, it is recommended to visit the attending physician on time, who will adjust the prescribed treatment. Do not take antiepileptic drugs without the knowledge of your doctor or exceed the prescribed dose. The higher the frequency of seizures, the greater the risk of injury and damage to the body. The type of seizures is also taken into account, since tonic-clonic seizures are more dangerous for the patient than non-generalized ones.

Those attacks in which a person’s consciousness is disturbed are also called dangerous. Higher doses of drugs disrupt the coordination of human movement and lead to falls. Patients with epilepsy should not be left unattended in water, especially when it comes to children.

Special recommendations

Surrounding a patient with epilepsy with overprotective care is not recommended. Protective measures should be carried out regardless of the presence of pathology. For example, when driving by road, all people need to be coordinated and attentive, and when riding a motorcycle, wear a safety helmet. When driving in road transport, the use of a protective helmet will be impractical and will not bring any effect in an emergency.

Protective measures should be applied when necessary. The situation depends on the stage and form of the disease, the presence of case features in epilepsy. If we are talking about advanced forms of epilepsy, serious precautions will be required on an ongoing basis. For example, in severe resistant cases, constant monitoring of the patient will be required. If the effect of the treatment is present and intensifies every day, the restrictions will be minimal.

Taking a bath

Medical professionals say that patients with such a diagnosis are strictly prohibited from taking a bath on their own without supervision. Such restrictions do not always make sense, since everything depends on the stage of the disease. Some people with epilepsy are allowed to drive. If there are frequent epileptic seizures, then monitoring the person while taking a bath is necessary.