Characterize institution-wide orthopedic complications during Epilepsy Monitoring Unit (EMU) admissions and identify risk factors for such injuries. 

Patients with epilepsy are at risk for orthopedic injuries secondary to seizures and falls. Risk factors include association of chronic anti-seizure medication use leading to development of osteopenia and osteoporosis. The most common orthopedic injuries are upper extremity fractures, vertebral fractures or dislocations. Patients undergoing EMU evaluation for characterization of seizures or pre-surgical evaluation of drug-resistant epilepsy expose patients to orthopedic injuries. While EMU admissions are considered safe, the incidence and impact of such injuries suffered in the EMU are not well studied.

This retrospective analysis from Jan 2020 to Dec 2023 at the University of Kansas Medical Center reviewed all EMU admissions for any orthopedic or spine consults during admission. These charts were further examined for clinical variables including epilepsy type, pre-EMU orthopedic injuries, any procedural interventions, and delay in management of epilepsy.

Orthopedic injuries in the EMU are infrequent but serious. Risk factors of developing orthopedic injuries include a history of osteoporosis and prior orthopedic injuries from seizures, particularly shoulder dislocations and thoracolumbar compression fractures. Orthopedic injuries should not preclude management of epilepsy with patients remaining at high risk for further injuries due to repeat seizures.