Neuropediatrics 2011; 42 - P023
DOI: 10.1055/s-0031-1273995

Spine fracture following generalized tonic-clonic seizures in a 16 years old girl. An unusual case

C Finetti 1, A Behrens 2, C Rülander 3, F Brassel 4, C Marschall 5, T Rosenbaum 2
  • 1Klinikum Duisburg, Klinik für Kinderheilkunde und Jugendmedizin, Abteilung für Neuropädiatrie, Duisburg, Germany
  • 2Klinikum Duisburg, Klinik für Kinderheilkunde und Jugendmedizin, Duisburg, Germany
  • 3Klinikum Duisburg, Klinik für Orthopädie und Unfallchirurgie, Duisburg, Germany
  • 4Klinikum Duisburg, Klinik für Radiologie und Neuroradiologie, Duisburg, Germany
  • 5Zentrum für Humangenetik und Laboratoriumsmedizin, Martinsried, Germany

Aims: Tonic-clonic seizures frequently result in accidental injuries most of which are bruises or scars. However, in rare cases even fractures of a vertebral body may occur in the course of an epileptic seizure.

Methods: We report on a 16-year-old girl who complained of backache following a first generalized tonic-clonic seizure. Clinical examination of the girl upon admission did not reveal any suspicious findings – except for the fact that she was dependant on a hearing aid. In addition the patient as well as her mother and sister showed strikingly blue sclera.

Results: CT scan of the spine demonstrated a fracture of the 8th thoracic vertebral body which could successfully be realigned and was stabilized using an internal fixator. The combination of a fracture, impaired hearing and blue sclera was suggestive of osteogenesis imperfecta which was later confirmed by detection of a mutation of the COL1A1 gene.

Conclusion: Backache in children and adolescents following a generalized tonic clonic seizure has to be taken seriously and warrants further examination. In most cases seizure-related backache might be attributable to heavy muscle forces in the course of an epileptic convulsion. In rare cases these muscle forces can also result in compression fractures of the spine. To our knowledge seizure-induced backache as leading symptom of a previously unknown osteogenesis imperfecta has not been described in the literature to date.