Convulsive seizure: More than just seizure.

Abstract

Seizure is a common medical problem and frequently encountered in the emergency department. Although the main problem seems to be a seizure, patients might have significant injuries. We describe a young man who sustained an anterior fracture dislocation of shoulder after a non-traumatic witnessed seizure. The present case demonstrates that forceful muscle contractions during convulsive seizures itself can cause a fracture dislocation of shoulder without trauma. Postictal depression of consciousness may hinder early diagnosis. Initial evaluations of these patients may fail to reveal this unsuspected diagnosis. Emergency physicians should be alert to significant injuries in patients presented to the emergency department with a seizure, even in the absence of external trauma. A complaint of pain after seizures raises a suspicion of fracture or dislocation and should be evaluated radiologically.