Nocturnal vertebral compression fracture. A presenting feature of unrecognized epileptic seizures
A. G. Aboukasm and B. J. Smith
Department of Neurology, Henry Ford Hospital and Health Sciences Center, Detroit, Mich, USA.
Bone fractures, especially vertebral compression fractures, are well-known
complications of convulsive seizures. Acute vertebral fractures of unclear
cause, often labeled idiopathic, may be due to unwitnessed epileptic
seizures. We reviewed the records of 2 patients with new onset of seizures
seen at the Adult Epilepsy Clinic at the Henry Ford Hospital, Detroit,
Mich, who had a history of vertebral compression fractures preceding the
diagnosis of epilepsy. The patients, who had no risk factors for pathologic
fractures, awoke with severe midback pain. X-ray films revealed thoracic
vertebral fractures in both patients. The first recognized seizure occurred
1 week later in 1 patient and 6 months later in the other. Nocturnal
vertebral compression fractures may be the presenting feature of
unwitnessed convulsive seizures, and evaluation for epilepsy should be
considered in cases of idiopathic vertebral compression fractures.
