Cause Of Convulsions Research Articles

Disease Pattern and Laboratory Profile of Febrile Convulsion among Admitted Children in SWMCH, Sylhet

Background: Febrile seizure is the most common cause of convulsion encountered in pediatric practice. Majority of febrile convulsions occurred in first two years of life. The incidence is slightly higher in boys than in girls, but they tend to occur earlier in girls. Aim of the study: This aim of the study was to evaluate the disease pattern and laboratory profile of febrile convulsion among the children admitted in SWMC. Materials and methods: This cross-sectional study was done in Sylhet Women’s Medical College Hospital from February 2021 to January 2022. Total 174 children aged in between 0-7 years who were admitted in Pediatric department with the complaints of fever and convulsion were included in the study. Data was collected by expert physician with structured questionnaire containing demographic profile, history, clinical examination and laboratory profile. Data were analyzed by descriptive manual. Results: The results showed that, there were 25 (14.44%) children in age group of 0-2, 108 (62%) in age group of 3-5 and 41 (23.56%) in age group of 6-7 years. The number of male subjects were higher 91 (52%) than female 83 (47%) in the study. The most frequent type of seizure was GTCS which was found in 148 (85%) cases. Leukopenia was found in 92 (52.87%) cases which was the most frequent finding. The most frequent type of disease was upper respiratory tract infection 52 (29.88%) followed by pneumonia 46 (26.43%), gastroenteritis 32 (18.39%), urinary tract infection 32 (18.39%) and otitis media 12(6.89%). Conclusion: In our study most of the children were 3-5 years of age with male preponderance. Upper respiratory tract infection was found as common cause of febrile convulsion and leucopenia, raised CRP were identified.

STUDY OF SERUM ZINC LEVELS IN CHILDREN WITH FEBRILE SEIZURES

Background: Febrile seizures are the most common cause of convulsions in children and a frequent cause of emergency hospital admissions. Trace elements like Zinc are found in small quantities in the body but have important structural functional roles in a variety of biological processes. There are studies identifying the role of hypozincemia in febrile seizures but so far no studies have documented hyperzincemia in febrile seizures. An objective was to study the association between serum zinc levels and febrile seizures in children in our set up. The study was cross Methods: sectional study done in B.Y.L. Nair Hospital, Mumbai, India from January 2017- November 2018 . A total of 147 children aged 6 months to 6 years fullling our inclusion and exclusion criteria were enrolled for the study. Children were classied into 3 groups of 50 each. Out of 3 groups rst group comprised of febrile seizure cases. The other 2 groups were control with rst being the febrile patients without convulsions and the other being children without any history of fever or convulsion. The concentration of serum zinc was measured by colorimetric method using a Fully automated analyser. The three groups included in the study were compared with respect to serum zinc level. All data was analysed with SPSS (Statistical Package for the Social Sciences) and variables were analysed with t-test, chi-square test and ANOVA test. All p-values below 0.05 were considered statistically signicant. Out of 147 children enrolled, majority of t Results: he children in case group were between 6 to 12 months (46.8%). Mean serum zinc level in cases was 112.5 ugm/dl. Serum zinc level was found signicantly high in cases of simple febrile seizures as compared to the controls (P<0.05). Amongst 47 cases 34.04% cases had hyperzincemia and 27.65% cases had hypozincemia. Thus cases with dysregulation in Zinc levels were 61.7%. This study reveals that there is a Conclusion: positive correlation between dysregulation (high as well as low) in serum zinc levels and febrile convulsions

A STUDY ON RELATIONSHIP BETWEEN SERUM ELECTROLYTE LEVELS AND FEBRILE CONVULSION IN CHILDREN IN A TERTIARY CARE CENTRE

Introduction: Febrile seizure (FS) is the most common cause of convulsions in children seen in between 6 to 60 months of age. Fever plays an important role in causing disturbances in uid and electrolyte balance which alters the mechanism of seizure activity and its threshold. To ndAim: out the relationship between serum electrolytes (calcium, magnesium, sodium, potassium) and simple febrile convulsion. Materials and Method: This cross sectional study was conducted on 120 children of age between 6 to 60 months. 60 children had fever with convulsion(cases) and 60 children had fever without convulsion(control). Serum level of sodium, potassium, calcium, magnesium were statistically analysed between both the groups In our study the difference in serum sodium, potassium, calcium levels in between case and control group are statisticallyResults: signicant, the p-value being <0.001, 0.017, 0.03 respectively. Our study concludes that changes in serum electrolytes may have aConclusion: role in the development of simple febrile convulsion and measurement of the serum electrolytes in a child with febrile seizures may help in predicting seizure recurrence within the same febrile illness.

Obstetric Outcomes of Pregnant Women with Eclampsia: A study in a Tertiary Care Hospital

Introduction: Usually, eclampsia is the commonest cause of convulsions in pregnancy next being epilepsy. Moreover, in developing countries like Bangladesh, perinatal condition in eclampsia is a major concern of infant injury. So, proper treatment planning and initiatives against eclampsia can save many lives by decreasing the total mortality and morbidity of child and mother. The aim of our study was to assess the perinatal outcomes of pregnant women with eclampsia in a tertiary care hospital in Bangladesh. Methods: This cross-sectional observational study was conducted at the Department of Obstetrics and Gynaecology in Rangpur Medical College, Rangpur, Bangladesh during the period from January 2020 to December 2020. Proper written consents form all the participants were obtained and the ethical committee of the mentioned hospital had approved the study before starting the intervention. In total 78 pregnant women with eclampsia were selected as the study population. A predesigned questioner was used in collecting patient data. All data were processed, analyzed and disseminated by using MS Office and SPSS version 23 as per need. Result: As final outcome we observed, there was not any case of multiple pregnancy or maternal mortality. Among total 78 fetus, cases of stillbirth (SB), early neonatal death (END), perinatal death (END + SB) and death after birth were found as 8%, 12%, 19% and 4% respectively. So, total case of neonatal death was found 35% whereas the survival rate was 65%. As neonatal complication among survived babies, frequencies of jaundice, septicemia and respiratory distress were found in 27%, 24% and 18% babies respectively who were noticeable. As maternal complication, cases of ICU admission, acute kidney injury and haemorrhagic stroke were found as 4%, 3% and 1% respectively. Conclusion: Stillbirth may be considered as the main component and prematurity may be considered as another important cause of perinatal mortality in obstetric management of delivery in pregnant mothers with eclampsia. Early referral of eclamptic patients, early resuscitative measures as well as good neonatal care can improve perinatal outcomes in such cases.

Evaluation of Patients Presenting With First Febrile Seizure.

IntroductionFebrile seizure (FS) is the most common cause of convulsion in children. In the present study, we evaluated patients presenting with FS.MethodsEighty-two patients aged between 6-60 months who presented to Mersin City Training and Research Hospital with the first febrile seizure between January 2020 and May 2021 were included in the study.ResultsOf the 82 patients included in our study, 42 (51,2%) were male and 40 were female (48,8%). Their average age at presentation of first febrile seizure was 21,05 ± 16,22 months. Fever focus was found in 32 patients (39,1%) with upper respiratory tract infection. Epileptic abnormality was observed in the EEG of six patients (7,3%) and antiepileptic medication was started in three of these patients.ConclusionsUpper respiratory tract infection, family history of FS, and family history of epilepsy are the main risk factors for the development of FS. Complex FS is a serious risk factor for the development of epilepsy.

ETIOLOGICAL EVALUATION OF SEIZURE IN CHILDREN ADMITTED IN TERTIARY CARE HOSPITAL OF NORTHERN INDIA

Introduction: Convulsions are one of the most common paediatric neurological disorder worldwide. It could either be idiopathic or secondary to disease process of brain. Incidence of convulsion is highest among children younger than 3 yrs. Aims And Objectives: Current study was done to know the proportion of idiopathic epilepsy and secondary seizures. It further aimed to identify various aetiologies of convulsion in children between 1month to15years of age. Materials And Methods: It was a descriptive study conducted in patients admitted in emergency and indoor of department of paediatrics, Patna Medical College and Hospital, over a period of 2 years from October 2014 to September 2016. Children from 1 month to 15 years of age with seizures were studied to know the various aetiologies and proportion of idiopathic or secondary seizures. Results: During study period, 200 children between ages 1 month to 15 years, with convulsion, were enrolled. Seizures were found to be more common in males (67.5%). Secondary seizures were present in 90% cases and idiopathic epilepsy accounted only for 10%. GTCS was the commonest type of seizure both in idiopathic epilepsy (100%) as well as in secondary seizure group (87.77%). Family history of seizure disorders was present in 13% of cases. Developmental delay was found in 11.5% cases, whereas 88.5% children were developmentally normal. Infective aetiologies were the commonest cause followed by febrile seizures. Febrile seizures were commonly seen in age group between 1yr - 5yrs (23.75%). Hypocalcemic seizures were mostly seen in the age group of 1month to 1 year (17.5%). Japanese encephalitis virus and dengue virus as a cause of viral meningoencephalitis were found in 10% and 5% respectively. Conclusion: Incidence of idiopathic epilepsy was less common than secondary seizures. GTCS was the commonest seizure type. CNS infection and febrile seizures were common causes of convulsion in this age group. Bacterial infections were the commonest CNS infections. Serum electrolytes, lumbar puncture, neuroimaging, EEG were important tools in reaching diagnosis

Features Of Intensive Therapy For Preeclampsia And Eclampsia

Preeclampsia and eclampsia have always been life-threatening for both mother and fetus. Predisposing factors are hypertension in pregnant women, kidney disease, as well as multiple pregnancies, a history of eclampsia and a family history, age or old age. The cause of convulsions is varying degrees of brain, tumor severity due to increased intracranial pressure or localized vascular spasms leading to cerebral hypoxia of ischemic anoxic genesis.

TO STUDY SERUM ZINC LEVEL IN CHILDREN WITH FEBRILE SEIZURE.

Background: Febrile seizures are the most common cause of convulsions in children. However, the exact underlying etiology and the pathophysiological mechanisms are yet to be established. Various theories have been put forward regarding the role of trace elements as predisposing factors in causing the convulsions. Among them, Zinc is the most interesting trace element whose role in diarrhea and pneumonia is well proven.
 Methods: Hospital based Prospective, Analytical, Case – Control study conducted on 100 patients were enrolled in the study out of which 50 were cases which were febrile convulsion patients and 50 were control who were age and weight matched children.
 Results: Mean zinc level was 69.80±13.13mcg/dl and 80.76±10.24 mcg/dl in study and control groups respectively and this difference was found statistically highly significant (p<0.001).
 Conclusion- This study establishes a definite relationship between zinc deficiency and febrile seizures thereby substantiating zinc as an important predisposing factor in febrile seizures.
 Keywords: Zinc, Epilepsy, Deficiency

The clinical convulsive profile in children admitted in the Department of paediatrics in Qena University Hospital; Epidemiological study

Background: Seizures are a potentially life threatening problem with a variety ofcauses.Objectives: The current study aimed to recognize different patterns of convulsionsamong children and identify different causes of convulsions in children with detection ofthe frequency of these causes.Patients and methods: We evaluated 400 children who presented with seizure disorder.Variables including demographics, clinical presentations, laboratory tests, brain imagingstudies, electroencephalography and hospital course were assessed and comparedbetween patients.Results: The mean age was 3.9 ± 3.5 years, 238 (59.5%) were males. Generalized tonicclonic(GTC) seizures were the most frequent type of seizures (62.5 %).The mostfrequent etiology for seizures was CP in 30 patients (7.5%) followed by CNS infectionin 16 patients (4%).Family history was positive in 44 patients (11%).Conclusion: The prevalence of seizures in children was common in males than femalesand common in preschool children than older children. The generalized tonic clonicseizures were the most common seizure type in children. Cerebral palsy and CNSinfection were common causes of seizures. EEG and neuroimaging study are helpful indiagnosis of causes of seizures.

A descriptive study on acute gastroenteritis with convulsion: 1-year analysis

Introduction Several etiologies explain the occurrence of seizures with acute gastroenteritis, such as electrolyte abnormalities and dehydration, a high fever, infectious fragments of pathogens crossing blood-brain barrier and causing significant central nervous system damage, septicemia, intracranial hemorrhage, and hypoglycemia. The aim of this study was to detect the frequency and etiology of convulsion in children with acute gastroenteritis admitted to Assiut University Children Hospital during 1 year from January 2017 to the end of December 2017. Patients and methods This is a one-year descriptive study that was carried out on 130 patients having acute gastroenteritis with convulsion, aged from 1 month to 5 years. Patients were divided according to the age into two groups: group 1, from 1 to 12 months of age, and group 2, from more than 1 to 5 years. All cases were subjected to full history, complete physical examination, and investigations, which included complete blood count, serum electrolytes, renal function tests, arterial blood gases, random blood sugar, and blood culture, which was done only when sepsis is suspected. Results The results show that the frequency of convulsion was 4.6%. The most common cause was electrolyte disturbance, which was noticed in 106 (81.5%) cases, followed by central nervous system infection, which was noticed in 39 (30%) cases, then septicemia and hypoglycemia, which were noticed in 13 (10%) cases each, then febrile convulsion, which was noticed in 11 (8.5%) cases [regarding febrile convulsions, there was a statistically significant difference between the two age groups (P = 0.027)], and lastly, intracranial hemorrhage, which was noticed in five (3.8%) cases. Conclusion Convulsion is one of the most serious complications associated with acute gastroenteritis. A younger age group (1–12 months) is more susceptible to complications than the older age group. Electrolyte disturbance is still a major cause of convulsion with acute gastroenteritis.

Case Report: Morphine withdrawal induced convulsions in an adult male patient

This case report describes a possible unknown complication of morphine withdrawal in a patient with persistent back pain, treated with intrathecal morphine pump infusion. The patient presented with left lower extremity edema. After excluding deep vein thrombosis by Doppler ultrasound and worsening of the swelling despite oral antibiotics, peripheral edema caused by intrathecal morphine was suspected. Twelve hours following the termination of his intrathecal morphine pump and initiation of inequivalent doses of oral morphine and tramadol, he developed convulsions. After metabolic and structural causes of convulsion were ruled out by blood tests and head imaging, equivalent doses of morphine were given. Then the patient regained full consciousness, and no additional seizures occurred. After that, opioid withdrawal emerged as the most likely explanation. Seizure is a life-threating condition; therefore, an awareness of this case is important and further studies are warranted to explore the potential association of opioid withdrawal and seizure.

A study of serum zinc levels in febrile seizures

Febrile seizures are the most common cause of convulsions in children. However, the exact underlying etiology and the pathophysiological mechanisms are yet to be established. Various theories have been put forward regarding the role of trace elements as predisposing factors in causing the convulsions. Among them, Zinc is the most interesting trace element whose role in diarrhea and pneumonia is well proven. Serum Zinc levels has been long associated with the febrile seizures. The main reason is still unknown for febrile seizures. In this prospective study, we evaluated zinc level in children with the first FS attack. Our findings can help clinicians with a fair idea of serum zinc levels about the use of zinc supplements for preventing the recurrence of febrile seizures via regulation of some neurological functions.

Bacterial Otitis by Klebsiella sp. as a Cause of Encephalitis in a Cat

Background: Meningoencephalitis in cats is usually related to infectious diseases but may also be caused by the extension of bacterial infections originated in the middle or inner ear. This paper seeks to report on a case of encephalitis due to an infection in the middle/inner ear in a 15-year-old cat. The diagnosis was made through brain CT scan and culture and antibiogram of material collected during a ventral osteotomy of the tympanic bulla and reported grave intravascular haemolysis associated to the treatment with antimicrobial imipenem with cilastatin sodium that has already been described in humans but not in small animals in the researched literature.Case: A 15-year-old, male, castrated, Siamese cat was brought to the Veterinary Clinical Hospital of the UFRGS. The animal presented pyrexia and hyporexia, tested negative in the immunoenzymatic test to detect antigens of the FeLV and antibodies of the FIV. The animal had a history of three episodes of tonic convulsion within two days and otitis that hadgone untreated for 10 months prior to the consultation, with apparent spontaneous remission. After blood tests, serum biochemistry profile, abdominal ultrasound scan, chest x-rays and CT scan was requested. It revealed middle and inner otitis in the right ear. It was performed a ventral osteotomy of the right tympanic bulla. Material was collected for culture and antibiogram. It was confirmed that the animal had an inner otitis of bacterial origin by multi-resistant Klebsiella spp. that was sensitive only to antimicrobial imipenem with cilastatin sodium. Fifteen days into the treatment with this antibacterial combination, grave haemolysis was observed, probably associated to the use of the medicine. The patient died on the 17th day of the treatment which was not interrupted as per its owner’s decision. At necropsy, both in the tympanic bulla and liver were found mucous content and whitish lumps. The material collected from the tympanic bulla and cerebrospinal liquid were cultured post-mortem when the bacteria Klebsiella sp. was isolated in the CNS and no bacterial growth was observed in the right tympanic bulla.Discussion: This makes it possible to deduce that there was an intracranial expansion of the otitis which would explain the convulsions and, that due to the use of the antimicrobial agent, the growth of Klebsiella sp. in the tympanic bulla was inhibited. The final diagnosis was bacterial otitis with probable bacterial migration to the brain and liver. Suppurativemeningoencephalitis caused by the expansion of the inflammation deriving from middle/inner otitis has been reported as being the cause of convulsions in cats with bacterial isolation. The bacteria that was isolated from the tympanic bulla is in agreement with the microbiota present in middle/inner otitis in cats. Regarding haemolysis, there are no reports thatlink the use of carbapenems in small animals to it or that mention what the safe therapeutic dosage should be if they were administered. Regarding humans, there have been various reports of haemolytic anaemia caused by this type of medicine including carbapenems. It is also known that, in in vitro tests, imipenem may cause inhibition due to competition from human erythrocyte-glutathione reductase, in charge of defending the erythrocyte against haemolysis. It has been concludedthat meningoencephalitis caused by middle/inner otitis must be included as a differential diagnosis in case of convulsions in cats. Additionally, further studies must be carried out in order to determine both the efficacy and the toxicity of carbapenems in veterinary patients, including studies of the occurrence of grave haemolysis after they are administered.Keywords: meningoencephalitis, computed tomography, convulsions, imipinem, carbapenems.

A comparative study of serum zinc levels in children with febrile seizures and children with fever without seizures in an urban referral hospital

Background: Febrile seizures are the most common cause of convulsions in children. However, the exact underlying etiology and the pathophysiological mechanisms are yet to be established. Various theories have been put forward regarding the role of trace elements as predisposing factors in causing the convulsions. Among them, Zinc is the most interesting trace element whose role in diarrhea and pneumonia is well proven. This study was done to know the correlation between zinc and febrile seizures, to estimate the serum levels of zinc in children with simple and complex febrile seizures and compare it with children with fever without seizures and to compare the levels of zinc in simple and complex febrile seizures.Methods: The study was conducted for a period of 6 months in the Department of Paediatrics, GMKMCH, and Salem. The study population included the children between 6 months to 6 years. During the study period 60 consecutive children with simple febrile seizures, 40 consecutive children with complex febrile seizures and 200 consecutive children with fever without seizures formed the study group. Serum zinc levels were measured in the three groups by using the calorimetric method.Results: The serum zinc levels were found to be low in 65% and 75% of children with simple and complex febrile seizures respectively. Only 20% of febrile children without convulsions had low zinc levels. Thus, a positive correlation was found between zinc deficiency and febrile convulsions.Conclusions: This study establishes a definite relationship between zinc deficiency and febrile seizures thereby substantiating zinc as an important predisposing factor in febrile seizures.

A study of febrile seizures in children in relation to iron deficiency anemia

Background: Febrile seizures are the most common cause of convulsions in children between 6 months to 5 years, occurring in 2-5% of children. Iron deficiency is postulated as a risk factor for febrile seizures in children and it is an easily correctable condition. The objective of the study was to study the clinical profile and risk factors of febrile convulsions and to establish an association between febrile seizure and iron deficiency anemia.Methods: The study was carried out in Department of Pediatrics, Dhiraj General Hospital, Piparia, a tertiary care teaching hospital. 34 cases and 34 controls were included in the study. Controls were children of same age group presenting with short febrile illness but without any seizures. Febrile seizures were defined according to the AAP (American Academy of Pediatrics) criteria. Iron deficiency was diagnosed by hematologic investigations of haemoglobin value < 11 g/dl, MCV <70 fL and RDW > 15.6%.Results: Iron deficiency anemia was present in 23.52% (8/34) of cases as compared to 17.64% (6/34) in the control group. Odds ratio was 1.436 (95% CI 0.439-4.669, p value 0.549), which suggest there is no significant association of iron deficiency anemia with febrile convulsions. Subgroup analysis for association of iron deficiency anemia with simple febrile convulsion cases showed Odds ratio of 1.11 (95% CI 0.298-4.138), which suggests there is poor association of iron deficiency anemia with simple febrile convulsions. Subgroup analysis for association of iron deficiency anemia with complex febrile convulsion cases showed Odds ratio of 2.809 (95% CI 0.521-15.041), which suggests there is poor association of iron deficiency anemia with complex febrile convulsions. Wide confidence interval indicates less sample size. Study with large sample size is required for reliable interpretation.Conclusions:The study reveals iron deficiency anemia is not a significant risk factor in children presenting with febrile seizures. Further study with large sample size is required.

Reduced serum calcium is a risk factor for febrile seizures

Background: Febrile seizure (FS) is the most common cause of convulsions in children. The objective of present work was to study the association between serum electrolytes and febrile seizures.Methods: Children in the age group of 6 month to 6 years with febrile seizures satisfying inclusion criteria and equal number of age and sex matched controls were subjected to estimation serum electrolytes and compared using appropriate statistical methods.Results: Serum Calcium levels in children with febrile seizures were reduced and this observation was statistically significant.Conclusions: Definite association was found between serum calcium levels and the occurrence of febrile seizures. Although serum calcium levels were not in the hypocalcemic range, they were decreased enough to cause a statistical significance in precipitating febrile seizures.

Clinicoetiological and Biochemical Profile of Neonatal Convulsions

Introduction: Neonatal seizures may present in 1-2% of term to almost 20% in preterm infants. Hypoxic ischemic encephalopathy, sepsis and bacterial meningitis are common causes. Biochemical abnormality and intra cranial bleed is also quiet common in this age. Aim of our study was to observe clinical presentation, to find common etiological factors and analysis of associated biochemical abnormality in newborn presented with neonatal convulsions in our hospital. Methods: Prospective hospital based observational study. From January 2014 to December 2014, total 168 newborns admitted with convulsions or developed convulsions during hospitalization, 154 were included in the study. After taking complete history and appropriate physical examination, blood sample was collected before instituting specific therapy. Investigations advised to all were complete blood count, sepsis screen, blood sugar, serum electrolytes. CSF study, serum bilirubin, USG cranium, CT scan or MRI was also ordered when indicated. Results: Cumulative frequency of neonatal convulsion in our study was 5.52%. Perinatal asphyxia was most common etiological factor in term or post term babies and presentation of seizures was early, intra cranial bleed and metabolic abnormality was common cause of convulsions in premature babies and presentation of seizure was somewhat late. Subtle seizure was most common type of fits followed by clonic type of seizures. Hypocalcemia was most common biochemical derangement. Conclusion: hypoxic ischemic encephalopathy was most common etiology of neonatal convulsions, presented with convulsions within 72 hours of life and subtle seizure and focal clonic or multifocal clonic was most common seizure type.

Evaluation of Clinical Features of 238 Cases With Febrile Convulsion

Febrile convulsion (FC) is defined as a seizure triggered by fever in children between 6 months and 5 years of age without an underlying central nervous system infection. It is the most common cause of convulsion in childhood, and 3% to 4% of children experience …

Febrile convulsions in preschool children Kashmir India

Background: Febrile convulsions are the most common cause of convulsions in children under five years of age. Objective of current study was to know the incidence, age and sex distribution of febrile convulsions in preschool children Kashmir India. Methods: A prospective hospital based study, carried out in the Department of Pediatrics, G.B. Pant Hospital, Government Medical College and Research Institute, Srinagar India from 1 July 2009 to 30 June 2010. All the hospitalized sick children who had febrile convulsions in the age group 1 month to 6 years of the age between 1 July 2009 to 30 June 2010. All children with febrile convulsions in the age group 1 month to 6 years were enrolled in this study. Variables recorded were demographics, clinical presentation, laboratory tests, and diagnosis and hospital course. Results: A total of 897 children in the age group 1 month to 6 years were admitted for recent seizures. Among these patients 545 (60.7%) had febrile convulsions. Among Febrile convulsions, 379 had typical febrile convulsion and 166 atypical febrile convulsions. Febrile convulsions were more common in males (308) than females (237). Febrile convulsions were more common in first three years of life. Conclusions: Febrile convulsions were the commonest cause of convulsions in children under five years of age and majority of them occurred in first two years of life. Typical febrile convulsion were common than atypical febrile convulsions.

A Rarely Seen Multilevel Thoracic Vertebral Fracture after a Nocturnal Hypoglycemic Convulsion Attack

A 49-year-old male presented with acute midthoracic severe back pain following a witnessed nocturnal convulsion attack. There was no history of trauma and the patient had a 23-year history of Type I diabetes mellitus. MRI scans of the thoracic spine revealed compression fractures at T5, T6, T7, and T8 vertebrae. The patient was treated conservatively. At 17 months after the initial diagnosis, the complaints of back pain had been resolved and the patient was able to easily undertake daily living activities. Hypoglycaemia is a common problem in diabetic patients treated with insulin. Convulsions may occur as a consequence of insulin-induced hypoglycemia. Nontraumatic compression fractures of the thoracic spine following seizures are a rare injury. Contractions of strong paraspinal muscles can lead to compression fracture of the midthoracic spine. Unrecognized hypoglycaemia should be considered to be a possible cause of convulsions in insulin-dependent diabetic patients. The aim of this report is to point out a case of rarely seen multilevel consecutive vertebrae fractures in a diabetic patient after a nocturnal hypoglycaemic convulsion attack.