ABSTRACT

There are multiple consequences of epilepsy that impact quality of life. While psychiatric comorbidities are some of the most commonly studied aspects, orthopedic complications are less frequently documented. The focus of the present study was shoulder dislocation related to epilepsy, and, unlike that of previous studies, the aim was to identify epilepsy-dependent risk factors in the development of joint disability.

Twenty-one patients of the Cerrahpaşa Faculty of Medicine epilepsy outpatient clinic were retrospectively identified as having had epilepsy-related shoulder dislocation between 1990 and 2013. Probable risk factors were evaluated in terms of demographic and clinical features. A report published by the International League Against Epilepsy (ILAE) in 2010 was used to classify seizure and epilepsy syndromes.

Median age at onset of epilepsy was 20 years, while median age at shoulder dislocation was 24. The seizure type that most commonly led to dislocation was bilateral convulsive (81%). Initial dislocations (IDs), those following any of the first 3 seizures, were identified in 45% of the population. Patients with ID tended to be older than those with late dislocation (LD) (p<0.001). Rate of recurrent dislocation was found to be higher in patients with early onset epilepsy, compared to those older than 20 years at diagnosis (p<0.05).

While, as expected, shoulder dislocation was most commonly caused by bilateral convulsive seizures, factors thought to impact severity of dislocation including seizure frequency, occurrence of status epilepticus (SE), response to treatment, and use of antiepileptic drugs (AEDs) that affect bone metabolism were found to have no influence on temporal development, affected side (bilateral or unilateral), or recurrence rate.

Keywords: Epilepsy, epilepsy-related complications, joint instability, seizure, shoulder dislocation