Incidence of five common fracture types in an institutional epileptic population

We have reviewed 4521 patient-years and analysed 185 066 seizures to calculate the incidence of five common fractures in an epileptic population. Only 25.0 per cent of these fractures were known to have occurred during a seizure. When age and sex matched against a 'normal population', there was an increased incidence of femoral neck fractures (5.2 x ), inter-trochanteric fractures (9.9 x ), ankle fractures (9.9 x ) and proximal humerus fractures (4.2 x ). Surprisingly, there was no increased incidence of wrist fractures. Overall, there was a 4.3 x increased risk for all fractures and 3.2 x increased risk of fractures not related to fits. There was no evidence for the first fracture occurring at a younger age in this population. The possible causes of this greatly increased risk are discussed.