Seizure-related injuries in northeast Thailand.

OBJECTIVE: The authors aimed to assess the frequency, characteristics, and risk of seizure-related injuries from traffic accidents, near-drowning, burns, fractures, head and soft tissue injuries. MATERIAL AND METHOD: Attending physicians assisted 300 consecutive seizure patients to complete a questionnaire. The types and frequency of injuries were then expressed in terms of the type of seizure and related activity. RESULTS: The male (154) and female (146) patients were between 13 and 91 years of age (mean, 36.27 +/- 14.55). The seizure types comprised of Generalized Tonic-Clonic (GTC) (26%), secondary GTCs (21%) and complex partials (19%). Secondary causes accounted for 34% of seizures, and post-stroke was the most common (25.5%). The total number of seizure events per year was 8,525 and of these 7,306 included a fall with soft tissue injury (70%), head injury (22%), near-drowning (3%), burns (3%) and fracture or dislocation (1%). The ranking of significant risk factors for injuries was: 1) GTC seizure; 2) seizure with a fall; and, 3) number of seizures. CONCLUSION: Seizure-related injuries are common among Thai epileptic patients; thus, consistent treatment and education about the risk of injury would protect patients.

Seizure presenting to the emergency department, Srinagarind Hospital.

The authors would like to evaluate the incidence, clinical manifestation, the appropriateness of treatment, and outcome of seizure at the emergency department (ED). All charts of patients who visited the ED of Srinagarind Hospital from 1 January 2003 to 31 December 2003 were reviewed. The profiles of patients and management at the ED were recorded. There were 33,508 cases who visited the ED with 104 cases (0.31%) presenting with seizure. Four cases (3.9%) were diagnosed as status epilepticus. Generalized tonic-clonic seizure was the most common type. Poor antiepileptic drug (AED) compliance with the low AED level was the main precipitating factor. The normal physical examination and routine laboratory tests were normal in the majority of patients. Phenytoin intravenous loading was the commonest initial treatment even in patients with non-status epilepticus. Fourteen patients (13.5%) were treated with intravenous diazepam even though seizures were discontinued. Sixty patients (57.7%) were discharged after seizure was controlled. The advice in seizure control was recorded in only 11 cases (10.6%). From this review, 12 patients presented at the ED for continuing medication without any seizures. In conclusion, seizure at the ED should be treated more appropriately with both laboratory investigation and drug treatment. Futhermore, patient education should be implemented.