Epilepsy-related injuries
Epilepsy-related injuries
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DOI：
10.1111/j.1528-1167.2006.00666.x
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发表时间：
2006-01-01
期刊：
影响因子：
5.6
通讯作者：
Wirrell, Elaine C.
中科院分区：
文献类型：
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作者：
Wirrell, Elaine C.
只有一项前瞻性对照研究比较了癫痫患者与无癫痫患者的意外伤害风险。癫痫组的风险略有增加，主要是由于癫痫发作直接导致的损伤。关于损伤类型，该研究发现仅头部和软组织损伤的发生率显著较高;然而，大多数损伤都是轻微的。一些回顾性的、基于人群的研究表明，更严重的损伤类型的发生率增加。浸没损伤的死亡率很高;癫痫儿童的浸没风险比一般人群高7.5-13.9倍。骨折的风险增加了约两倍，直接由骨折引起的损伤引起，或由药物引起的骨密度降低引起。癫痫发作引起的烧伤占烧伤科收治人数的1.6%至3.7%。患有癫痫的司机发生机动车事故的风险似乎也增加了，尽管幅度不大。有几个因素使癫痫患者的受伤风险更高。癫痫发作导致福尔斯跌倒会增加脑震荡和其他伤害的风险。癫痫发作频率较高、无癫痫发作间期较长、合并注意力缺陷障碍或认知障碍也可能增加损伤风险。虽然为了保护癫痫患者的安全，有必要采取一些限制措施，但不适当的限制可能会进一步限制独立性的实现。鉴于浸水损伤的高发病率和死亡率，活动性癫痫患者应仅在监督下洗澡或游泳;然而，淋浴是一种合理的选择。建议适当补充维生素D和钙，并定期测量骨质疏松风险人群的骨密度。
Only one prospective, controlled study has compared the risk of accidental injury in persons with epilepsy to controls without seizures. A mildly increased risk in the epilepsy group was found, predominantly due to injuries that result directly from a seizure. With regard to injury type, this study found significantly higher rates of only head and soft tissue injury; however, most injuries were minor. Several retrospective, population-based studies have suggested increased rates of more serious injury types. Submersion injury has a high mortality; the risk of submersion in children with epilepsy is 7.5-13.9 fold higher than in the general population. The risk of fracture is elevated approximately twofold, either resulting directly from seizure-induced injury or predisposed by drug-induced reduction in bone mineral density. Burns due to seizures account for between 1.6% and 3.7% of burn unit admissions. The risk of motor vehicle accidents in drivers with epilepsy also appears increased, albeit marginally.Several factors predispose to a higher risk of injury among those with epilepsy. Seizures resulting in falls increase the risk of concussion and other injuries. Higher seizure frequency, lack of a prolonged seizure-free interval, comorbid attention deficit disorder, or cognitive handicap may also increase the risk of injury.While some restrictions are necessary to protect the safety of the person with epilepsy, undue limitations may further limit achievement of independence. Given the high morbidity and mortality of submersion injury, those with active epilepsy should bathe or swim only with supervision; however, showering is a reasonable option. Appropriate vitamin D and calcium supplementation and periodic measurement of bone mineral density in those at risk for osteopenia are recommended.