Department of Orthopedics at Plainview Hospital, Northwell Health, Plainview, New York.
JBJS Case Connect. 2020 Jan-Mar;10(1):e0190. doi: 10.2106/JBJS.CC.19.00190.
Two elderly women with significant medical comorbidities presented to a community hospital setting after new-onset generalized seizure activity while in bed without a history of trauma. Both were diagnosed by computed tomography scan with bilateral acetabular fractures. Owing to altered mental status from a postictal period, both were unable to be reliably assessed for pain, which resulted in a diagnostic delay.
These cases highlight the importance of a proper secondary survey on mentally altered patients even without a history of significant trauma, a high index of suspicion for associated injuries in seizure patients, and the use of appropriate advanced imaging.
两名老年女性均有严重的合并症，在无创伤史的情况下于床上出现新发全身性癫痫发作活动后，就诊于社区医院。两人均经计算机断层扫描诊断为双侧髋臼骨折。由于癫痫发作后意识状态改变，两人均无法可靠评估疼痛，导致诊断延迟。
这些病例强调了即使没有明显创伤史，对意识改变的患者进行适当的二次检查、对癫痫发作患者存在相关损伤保持高度怀疑、以及使用适当的高级影像学检查的重要性。
