The costs of trauma caused by seizures: can they be reduced?

This study surveyed admissions of patients with trauma caused by seizures from a population of over 400 000 to a Regional Neurosurgery, Plastic Surgery, Orthopaedic Surgical Services and a short-stay ward. Information on duration of epilepsy, seizure type, antiepileptic drugs (AEDs) and the co-existence of other neurological or psychiatric factors was reviewed and the hospital costs calculated. Twelve patients (eight males, four females, aged 28 to 78 years) had 13 admissions with 14 injuries caused by seizures during the period August 1995 to November 1998 (1% of the total admissions with the diagnosis of epilepsy). Seven had head-injuries, four had limb fractures or dislocations, two had burns and one had severe lacerations. The average duration of stays were between 1 day (short-stay ward) and 9-24 days for the three major services. The direct healthcare costs of this small group were high ( Ł 49 421) or Ł 3802 per traumatic incident. Clinical review suggested that the trauma could have been prevented by alternative care in seven patients at the most optimistic. Epilepsy is uncommon as a cause of severe trauma, the seizures may be difficult to prevent and the direct healthcare costs are high.