Adults With Epilepsy Experience High Frequency of Seizure-Related Injures

Adults with epilepsy experience a high frequency of seizure-related injuries regardless of risk factors at onset of epilepsy and during the previous year, according to a perspective study published in the journal Epilepsy & Behavior.

Researchers recruited 72 adults with epilepsy (38 women; mean age, 45.8 years; mean length of seizure disorder, 24.0 years) who received anti-seizure medications at PUC Campinas University Hospital in Campinas, Brazil from August 2020 to September 2021. The family members of patients with epilepsy that did not have a history of diseases were included as the control group. Individuals in the control group were matched by age, gender, and socioeconomic status to participants with epilepsy.

To analyze the occurrence of seizure-related injuries since epilepsy onset and in the previous year, researchers had participants complete several questionnaires and examinations, including:

• Seizure Severity Questionnaire (SSQ): measured by seizure severity (score ranging from 0-7; mild to severe) and global assessment (total score) of the SSQ, measured using 13 items on a Likert scale (score between 0-91)
• Mini-Mental State Examination (MMSE)
• Quality of Life in Epilepsy Inventory (QOLIE-31)

Individuals in the control group, specifically, only reported personal demographics and history of accidents.

Researchers also looked at risky activities performed since the onset of epilepsy and during the previous year. These included:

• Driving a car
• Skateboarding
• Riding a bicycle
• Working with dangerous machinery
• Performing household chores, such as cooking and ironing

Follow-up data were retrieved via diary entries 12 months postevaluation.

Upon disease onset, seizure-related injuries were seen in 55 cases (76.3%) of reported injuries and 17 cases (23.6%) occurred in the previous year, respectively. Severe seizure-related injuries resulted in hospitalization in 26 cases (47.2%), and surgeries in 14 cases (25.4%), respectively. Types of injuries ranged from artificial wounds (cuts/ puncture wounds) to head trauma and fractures/dislocations.

Higher SSQ scores were associated with a higher frequency of seizure-related injuries. Younger adults with epilepsy and adults with onset of epilepsy at a young age, reported more cases of seizure-related injuries. Also, the youngest adults in the study experienced greater frequency of seizures, had more seizure-related injuries during the previous year, and reported greater severity of seizures, according to SSQ results.

The younger epilepsy subgroup is also frequently prescribed more than 1 antiseizure medication and live a more restrictive lifestyle than those without seizure-related disorders.

Researchers did not find a relationship between seizure-related injuries and QOLIE-31 scores.

Adults with epilepsy reportedly had a more restrictive lifestyle compared with control individuals and engaged less in risky activities. Compared with control group individuals, adults with epilepsy were less likely to have a driver’s license [chi-square test, 16 (22.2%) vs 39 (65%); P <.001]; do less household chores [45, (62.5%) vs 50 (83.3%); P =.008]; and ironing [39 (54.1%) vs 43 (71.6); P =.039]. Overall, they were less likely to practice risky activities than control group individuals. Adults with epilepsy who did engage in riskier activities (n=11; 20%), had a longer mean length of seizure disorder, and medical visits.

Researchers did not find a relationship with the frequency of injuries related to risky activities, the total number of seizure-related injuries, and other epilepsy variables.

During follow-up, the researchers noted that “guidelines for better control of seizures and preventive measures for risky activities should be implemented to maximize people with epilepsy safety.”

Study limitations include small sample population and use of MMSE for cognitive screening.