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Seizure as a cause of fracture

Department of Clinical Neurosciences, Brown University, Providence, and the Department of Internal Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI.

Of 2,800 patients admitted to hospital with a diagnosis of seizure, 1.1% (30/2,800) sustained fracture. Of these, 0.5% (15/2,800) had fracture due to direct trauma, 0.3% (7/2,800) had fracture as a consequence of seizure alone, and in 0.3% (8/2,800) the etiology was not determined. In the trauma group, 11 of 17 fractures involved the skull, nasal bones, and clavicle, while in the nontrauma group, the proximal humerus was the site in 6 of 9 fractures. These findings indicate that fracture is an uncommon complication of seizure and is extremely rare in the absence of trauma where, however, the fracture may be pathognomonic (bilateral posterior dislocation or fracture-dislocation of the shoulder) or highly suggestive (unilateral posterior dislocation, fracture-dislocation of the shoulder) of seizure.

Address correspondence and reprint requests to Dr. Finelli, Memorial Hospital of Rhode Island, Pawtucket, RI 02860.

Received October 11, 1988. Accepted for publication in final form December 29, 1988.

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