Seizure related accidents and injuries in childhood.

Several studies show that the risk of accidents involving patients with epilepsy is much higher compared to the general population. The objective of this study was to identify the frequency and type of seizure related injuries in children diagnosed with epilepsy. In addition we also assessed possible risk factors associated with this seizure related accidents in childhood. This study was conducted at the pediatric epilepsy clinic of Unicamp, from January 2005 to August 2006. We evaluated 100 consecutive children with epilepsy. Parents were interviewed by one of the authors using a structured questionnaire that included questions about seizure related accidents and related injuries. Forty-four patients reported seizure related accidents. Eighteen patients needed medical assistance at an emergency room due the severity of their seizure related accident. Forty patients reported having a seizure related accident prevented by a bystander. Another 14 patients reported avoiding a seizure related accident by luck alone. Contusions and lacerations were the most common type of lesion associated with seizures. Patients with symptomatic/probable symptomatic epilepsy and those using higher numbers of anti-epileptic drugs (AEDs) were at greater risk for seizure related accidents (p<0.05). We conclude that patients with symptomatic/probable symptomatic epilepsy and on multiple AEDs are at increased risk of seizure related accidents. Parents and caretakers should be even more cautious about risk of injury in such patients.

Seizure related accidents and injuries in childhood / Acidentes e lesões associados às crises epilépticas na infância

Several studies show that the risk of accidents involving patients with epilepsy is much higher compared to the general population. The objective of this study was to identify the frequency and type of seizure related injuries in children diagnosed with epilepsy. In addition we also assessed possible risk factors associated with this seizure related accidents in childhood. This study was conducted at the pediatric epilepsy clinic of Unicamp, from January 2005 to August 2006. We evaluated 100 consecutive children with epilepsy. Parents were interviewed by one of the authors using a structured questionnaire that included questions about seizure related accidents and related injuries. Forty-four patients reported seizure related accidents. Eighteen patients needed medical assistance at an emergency room due the severity of their seizure related accident. Forty patients reported having a seizure related accident prevented by a bystander. Another 14 patients reported avoiding a seizure related accident by luck alone. Contusions and lacerations were the most common type of lesion associated with seizures. Patients with symptomatic/probable symptomatic epilepsy and those using higher numbers of anti-epileptic drugs (AEDs) were at greater risk for seizure related accidents (p<0.05). We conclude that patients with symptomatic/probable symptomatic epilepsy and on multiple AEDs are at increased risk of seizure related accidents. Parents and caretakers should be even more cautious about risk of injury in such patients.

Vários estudos mostram que o risco de acidentes envolvendo pacientes com epilepsia é muito maior do que na população geral. O objetivo desse estudo foi identificar a freqüência e tipo de acidentes relacionados a crises epilépticas em crianças com diagnóstico de epilepsia. Além disso, também avaliamos os fatores de risco associados às crises epilépticas na infância. Esse estudo foi realizado em nosso ambulatorio de epilepsia infantil da Unicamp, no período de janeiro de 2005 a agosto de 2006. Avaliamos 100 pacientes consecutivos. Os pacientes foram entrevistados por um dos autores, utilizando-se um questionário sobre acidentes e lesões associadas às crises epilépticas. Quarenta e quatro pacientes apresentaram acidentes relacionados às crises epilépticas. Dezoito pacientes precisaram assistencia médica em pronto socorro devido à gravidade das lesões. Quarenta pacientes relataram que um acidente foi evitado devido ao socorro de uma outra pessoa. Outros 14 pacientes relataram que um acidente foi evitado apenas por sorte. Contusões e lacerações foram os tipos de lesão mais comuns. Pacientes com epilepsia sintomática ou provavelmente sintomática, e pacientes em uso de politerapia apresentaram maior risco de acidentes relacionados às crises epilepticas (p<0.05). Concluímos que pacientes com epilepsia sintomática/provavelmente sintomática em uso de politerapia apresentam risco de acidentes elevado. Familiares e cuidadores desses pacientes devem ser ainda mais cautelosos sobre o risco de lesão associada às crises epilépticas.