Most superstitious fears surrounding epilepsy have vanished
since the Dark Ages. However, while no one believes any
more that seizures are a manifestation of diabolic possession,
some of the fears we do have might be founded on old wives
tales rather than facts. A study in the November 9 issue
of Neurology found that reports of the risk of
injury during seizures may have been greatly exaggerated.
Dr Elson So, a Mayo Clinic neurologist,
led a team of American, Indian and Australian researchers
in a study of the true prevalence of injuries in epileptics.
"People with well-controlled epilepsy should not arbitrarily
be considered at higher risk of injury than those without
epilepsy," says Dr So. "It's important to find a balance
between seizure precaution and the freedom to enjoy
life."
CRASH
TEST
The team studied 247 residents of Rochester, MN, who
were diagnosed with epilepsy between 1975 and 1984,
and followed these subjects until last year. In the
final analysis, 62 seizure-related injuries were identified
in 39 patients. Four out of five injuries involved cranial
soft tissue contusions or lacerations. Eighty-two percent
of all injuries occurred during generalized convulsive
seizures. The study did not, however, count injuries
to the tongue and mouth.
Dr So says previous studies have
overestimated risk by studying subjects with uncontrolled
epilepsy then applying their findings to the wider epileptic
population. "Our study showed if you take all patients
with epilepsy as a group, you'll find the injury risk
is actually very low."
Naturally some patients were more
at risk than others. Factors contributing to higher
risk for injury were: greater number of anti-epileptic
drugs used, less independent living situation, higher
Rankin score (a measure of disability in which a score
of 0 represents no disability and 5 represents total
disability), history of convulsive seizures or atonic
seizures and high seizure frequency.
"Unnecessary restrictions of activity
can adversely affect quality of life, often to a more
serious extent than seizure attacks do. Ignoring the
risk of injuries may have disastrous consequences for
some people with epilepsy. However, overestimating the
risk of injuries may unfairly impact on the rights of
those with well-controlled epilepsy," concludes Dr So.
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