Abstract
Numerous orthopaedic injuries can follow a seizure and are often diagnosed late. This is the first documented case of a missed bilateral anterior shoulder dislocation following a seizure. The possible reasons for the greater incidence of posterior dislocations are examined and why bilateral anterior dislocations following a seizure are so rare. The article discusses the reasons for the delay and highlights potential pitfalls and learning points for junior emergency department doctors.
Highlights
Muscular contractions generated during a seizure can lead to a variety of musculoskeletal injuries
Journal of Medical Case Reports 2007, 1:20 http://www.jmedicalcasereports.com/content/1/1/20 to be a higher incidence of delayed diagnosis of such an injury following a presentation with an indirect complaint, such as a seizure
The bilateral anterior shoulder dislocations following a seizure may occur from the trauma of the shoulders striking the floor after the collapse
Summary
Muscular contractions generated during a seizure can lead to a variety of musculoskeletal injuries. Bilateral shoulder dislocations are uncommon, usually presenting as posterior dislocations following epilepsy, electric shock or electroconvulsive therapy [1]. A twenty five year old man presented to the Emergency Department following an unwitnessed collapse. After playing on his computer for ten hours overnight he got up from his computer at 4 am and lost consciousness without any warning. The patient was disorientated, exhausted with generalised weakness and subsequent difficulty in moving either arm. Both shoulders were documented as symmetrical with no injury to the soft tissues and grossly neurovascularly intact but were uncomfortable and had limited range of movement. After four weeks of physiotherapy shoulder movements returned to normal
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