Epilepsy Behav. 2025 Jul 19;171:110598. doi: 10.1016/j.yebeh.2025.110598. Online ahead of print.
ABSTRACT
OBJECTIVE: To analyze the lateralizing value of shoulder dislocation in seizure semiology of patients with focal epilepsy.
METHODS: We retrospectively reviewed the charts of patients with shoulder dislocation secondary to seizures who were seen at our institution from April 1, 2002 to October 15, 2023.
RESULTS: A total of 87 patients met the inclusion criteria. Forty-four (50.6 %) had generalized epilepsy with tonic-clonic seizures, 22 (25.3 %) had focal epilepsy, and 21 (24.1 %) had epilepsy with unknown onset tonic-clonic seizures. Of the 22 patients who had focal epilepsy, 20 (91 %) had contralateral shoulder dislocation (95 % CI [71-99 %]). This association between seizure focus laterality and contralateral shoulder dislocation was statistically significant (Fisher’s exact test, p < 0.001).
SIGNIFICANCE: We found that shoulder dislocations were more common in patients with generalized compared to focal epilepsy. More important, most patients with focal epilepsy had contralateral shoulder dislocation. We think that this can serve as a potential novel lateralizing sign during the presurgical epilepsy evaluation, though it requires validation in larger, prospective studies.
PMID:40684517 | DOI:10.1016/j.yebeh.2025.110598
