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Introduction <p>Seizure-induced trauma is a rare but severe complication that can mimic high-energy trauma and is often underrecognized. This case demonstrates the potential for complex multisystem injuries from a first-time seizure.</p> Case Presentation <p>A 69-year-old male with no history of seizures presented following a first-time generalized tonic–clonic seizure. He was found to have bilateral shoulder dislocations, bilateral acetabular fractures, and vertebral compression fractures. Clinical examination also revealed signs of acute left lower leg ischaemia.</p> Diagnosis and Interventions <p>Pan-CT and vascular imaging confirmed multiple musculoskeletal injuries and an acute occlusion of the dorsalis pedis artery. Orthopedic management included open reduction and internal fixation (ORIF) of the right shoulder and left acetabulum, and reverse total shoulder replacement (rTSR) of the left shoulder. The right acetabulum was treated non-operatively.</p> Outcome <p>The patient’s hospital course was complicated by delirium, pneumonia, and acute kidney injury. He was discharged after 28&#xa0;days to a rehabilitation facility with improving neurological function and orthopedic recovery. At six months, he was ambulating independently for 500&#xa0;m with a single-point stick and reported no residual shoulder limitations.</p> Conclusion <p>Seizure-induced polytrauma presents significant diagnostic and therapeutic challenges, especially in the absence of external trauma. This case highlights the importance of a high index of suspicion, multidisciplinary care, and osteoporosis screening in patients presenting with seizure-related injuries.</p>

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Complex Seizure-Related Multi-Trauma: A Case Report of Severe Orthopaedic Injury

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月6日

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  • Ayham Yasein,
  • Campbell Fisher,
  • Jack Allport,
  • Martin Kelly,
  • Raf Asaid,
  • Arvind Jain

摘要

Introduction

Seizure-induced trauma is a rare but severe complication that can mimic high-energy trauma and is often underrecognized. This case demonstrates the potential for complex multisystem injuries from a first-time seizure.

Case Presentation

A 69-year-old male with no history of seizures presented following a first-time generalized tonic–clonic seizure. He was found to have bilateral shoulder dislocations, bilateral acetabular fractures, and vertebral compression fractures. Clinical examination also revealed signs of acute left lower leg ischaemia.

Diagnosis and Interventions

Pan-CT and vascular imaging confirmed multiple musculoskeletal injuries and an acute occlusion of the dorsalis pedis artery. Orthopedic management included open reduction and internal fixation (ORIF) of the right shoulder and left acetabulum, and reverse total shoulder replacement (rTSR) of the left shoulder. The right acetabulum was treated non-operatively.

Outcome

The patient’s hospital course was complicated by delirium, pneumonia, and acute kidney injury. He was discharged after 28 days to a rehabilitation facility with improving neurological function and orthopedic recovery. At six months, he was ambulating independently for 500 m with a single-point stick and reported no residual shoulder limitations.

Conclusion

Seizure-induced polytrauma presents significant diagnostic and therapeutic challenges, especially in the absence of external trauma. This case highlights the importance of a high index of suspicion, multidisciplinary care, and osteoporosis screening in patients presenting with seizure-related injuries.