{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T01:33:56Z","timestamp":1768008836446,"version":"3.49.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T00:00:00Z","timestamp":1594339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T00:00:00Z","timestamp":1594339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>To evaluate the incidence and risk factors of generalized convulsive seizure (GCS)-related fractures and injuries during video-EEG monitoring.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We analyzed all GCSs in patients undergoing video-EEG-monitoring between 2007 and 2019 at epilepsy centers in Frankfurt and Marburg in relation to injuries, falls and accidents associated with GCSs. Data were gathered using video material, EEG material, and a standardized reporting form.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 626 GCSs from 411 patients (mean age: 33.6\u00a0years; range 3\u201374\u00a0years; 45.0% female) were analyzed. Severe adverse events (SAEs) such as fractures, joint luxation, corneal erosion, and teeth loosening were observed in 13 patients resulting in a risk of 2.1% per GCS (95% CI 1.2\u20133.4%) and 3.2% per patient (95% CI 1.8\u20135.2%). Except for a nasal fracture due to a fall onto the face, no SAEs were caused by falls, and all occurred in patients lying in bed without evidence of external trauma. In seven patients, vertebral body compression fractures were confirmed by imaging. This resulted in a risk of 1.1% per GCS (95% CI 0.5\u20132.2%) and 1.7% per patient (95% CI 0.8\u20133.3%). These fractures occurred within the tonic phase of a GCS and were accompanied by a characteristic cracking noise. All affected patients reported back pain spontaneously, and an increase in pain on percussion of the affected spine section.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>GCSs are associated with a substantial risk of fractures and shoulder dislocations that are not associated with falls. GCSs accompanied by audible cracking, and resulting in back pain, should prompt clinical and imaging evaluations.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00415-020-10065-5","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T15:03:51Z","timestamp":1594393431000},"page":"3632-3642","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Risk incidence of fractures and injuries: a multicenter video-EEG study of 626 generalized convulsive seizures"],"prefix":"10.1007","volume":"267","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2234-4659","authenticated-orcid":false,"given":"Katharina","family":"Frey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-2562","authenticated-orcid":false,"given":"Johann Philipp","family":"Z\u00f6llner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6298-0513","authenticated-orcid":false,"given":"Susanne","family":"Knake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3451-8938","authenticated-orcid":false,"given":"Yulia","family":"Oganian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Kay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Mahr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fee","family":"Keil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8226-1674","authenticated-orcid":false,"given":"Laurent M.","family":"Willems","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katja","family":"Menzler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7571-8496","authenticated-orcid":false,"given":"Sebastian","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1545-7364","authenticated-orcid":false,"given":"Susanne","family":"Schubert-Bast","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3989-7471","authenticated-orcid":false,"given":"Felix","family":"Rosenow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6288-9915","authenticated-orcid":false,"given":"Adam","family":"Strzelczyk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,10]]},"reference":[{"issue":"10","key":"10065_CR1","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.4065\/77.10.1111","volume":"77","author":"GD Cascino","year":"2002","unstructured":"Cascino GD (2002) Clinical indications and diagnostic yield of video-electroencephalographic monitoring in patients with seizures and spells. Mayo Clin Proc 77(10):1111\u20131120. https:\/\/doi.org\/10.4065\/77.10.1111","journal-title":"Mayo Clin Proc"},{"issue":"4","key":"10065_CR2","first-page":"247","volume":"99","author":"P Boon","year":"1999","unstructured":"Boon P, Michielsen G, Goossens L, Drieghe C, D'Have M, Buyle M, Vonck K, Naessens B, De Paemeleere F, Goethals I, Thiery E, Vandekerckhove T, De Reuck J (1999) Interictal and ictal video-EEG monitoring. Acta Neurol Belg 99(4):247\u2013255","journal-title":"Acta Neurol Belg"},{"issue":"3","key":"10065_CR3","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/0887-8994(95)00021-7","volume":"12","author":"LS Chen","year":"1995","unstructured":"Chen LS, Mitchell WG, Horton EJ, Snead OC 3rd (1995) Clinical utility of video-EEG monitoring. Pediatr Neurol 12(3):220\u2013224. https:\/\/doi.org\/10.1016\/0887-8994(95)00021-7","journal-title":"Pediatr Neurol"},{"issue":"12","key":"10065_CR4","doi-asserted-by":"publisher","first-page":"2625","DOI":"10.1007\/s10072-019-04022-y","volume":"40","author":"YW Cho","year":"2019","unstructured":"Cho YW, Motamedi GK, Kim KT (2019) The clinical utility of non-invasive video-electroencephalographic monitoring has been diversifying. Neurol Sci 40(12):2625\u20132631. https:\/\/doi.org\/10.1007\/s10072-019-04022-y","journal-title":"Neurol Sci"},{"issue":"Pt 9","key":"10065_CR5","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1093\/brain\/124.9.1683","volume":"124","author":"F Rosenow","year":"2001","unstructured":"Rosenow F, L\u00fcders H (2001) Presurgical evaluation of epilepsy. Brain 124(Pt 9):1683\u20131700","journal-title":"Brain"},{"issue":"4","key":"10065_CR6","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1002\/epi4.12078","volume":"2","author":"J Dobesberger","year":"2017","unstructured":"Dobesberger J, H\u00f6fler J, Leitinger M, Kuchukhidze G, Zimmermann G, Thomschewski A, Unterberger I, Walser G, Kalss G, Rohracher A, Neuray C, Kobulashvili T, Holler Y, Trinka E (2017) Personalized safety measures reduce the adverse event rate of long-term video EEG. Epilepsia Open 2(4):400\u2013414. https:\/\/doi.org\/10.1002\/epi4.12078","journal-title":"Epilepsia Open"},{"issue":"3","key":"10065_CR7","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1111\/j.1528-1167.2010.02782.x","volume":"52","author":"J Dobesberger","year":"2011","unstructured":"Dobesberger J, Walser G, Unterberger I, Seppi K, Kuchukhidze G, Larch J, Bauer G, Bodner T, Falkenstetter T, Ortler M, Luef G, Trinka E (2011) Video-EEG monitoring: safety and adverse events in 507 consecutive patients. Epilepsia 52(3):443\u2013452. https:\/\/doi.org\/10.1111\/j.1528-1167.2010.02782.x","journal-title":"Epilepsia"},{"key":"10065_CR8","doi-asserted-by":"publisher","first-page":"106718","DOI":"10.1016\/j.yebeh.2019.106718","volume":"102","author":"F Cox","year":"2020","unstructured":"Cox F, Reus E, Widman G, Zwemmer J, Visser G (2020) Epilepsy monitoring units can be safe places; a prospective study in a large cohort. Epilepsy Behav 102:106718. https:\/\/doi.org\/10.1016\/j.yebeh.2019.106718","journal-title":"Epilepsy Behav"},{"issue":"4","key":"10065_CR9","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1111\/epi.13670","volume":"58","author":"RS Fisher","year":"2017","unstructured":"Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, Jansen FE, Lagae L, Moshe SL, Peltola J, Roulet Perez E, Scheffer IE, Zuberi SM (2017) Operational classification of seizure types by the international league against epilepsy: position paper of the ILAE commission for classification and terminology. Epilepsia 58(4):522\u2013530. https:\/\/doi.org\/10.1111\/epi.13670","journal-title":"Epilepsia"},{"key":"10065_CR10","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.seizure.2020.02.018","volume":"78","author":"F Rosenow","year":"2020","unstructured":"Rosenow F, Akamatsu N, Bast T, Bauer S, Baumgartner C, Benbadis S, Bermeo-Ovalle A, Beyenburg S, Bleasel A, Bozorgi A, Brazdil M, Carreno M, Delanty N, Devereaux M, Duncan J, Fernandez-Baca Vaca G, Francione S, Garcia Losarcos N, Ghanma L, Gil-Nagel A, Hamer H, Holthausen H, Omidi SJ, Kahane P, Kalamangalam G, Kanner A, Knake S, Kovac S, Krakow K, Kr\u00e4mer G, Kurlemann G, Lacuey N, Landazuri P, Lim SH, Londono LV, LoRusso G, L\u00fcders H, Mani J, Matsumoto R, Miller J, Noachtar S, O'Dwyer R, Palmini A, Park J, Reif PS, Remi J, Sakamoto AC, Schmitz B, Schubert-Bast S, Schuele S, Shahid A, Steinhoff B, Strzelczyk A, Szabo CA, Tandon N, Terada K, Toledo M, van Emde BW, Walker M, Widdess-Walsh P (2020) Could the 2017 ILAE and the four-dimensional epilepsy classifications be merged to a new \u201cIntegrated Epilepsy Classification\u201d? Seizure 78:31\u201337. https:\/\/doi.org\/10.1016\/j.seizure.2020.02.018","journal-title":"Seizure"},{"issue":"Suppl 1","key":"10065_CR11","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/j.1528-1167.2006.00666.x","volume":"47","author":"EC Wirrell","year":"2006","unstructured":"Wirrell EC (2006) Epilepsy-related injuries. Epilepsia 47(Suppl 1):79\u201386","journal-title":"Epilepsia"},{"issue":"6","key":"10065_CR12","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1097\/EDE.0b013e3181577654","volume":"18","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP (2007) Strobe initiative\u2014The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Epidemiol 18(6):800\u2013804. https:\/\/doi.org\/10.1097\/EDE.0b013e3181577654","journal-title":"Epidemiol"},{"issue":"8","key":"10065_CR13","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1111\/epi.13449","volume":"57","author":"F Rosenow","year":"2016","unstructured":"Rosenow F, Bast T, Czech T, Feucht M, Hans VH, Helmstaedter C, Huppertz HJ, Noachtar S, Oltmanns F, Polster T, Seeck M, Trinka E, Wagner K, Strzelczyk A (2016) Revised version of quality guidelines for presurgical epilepsy evaluation and surgical epilepsy therapy issued by the Austrian, German, and Swiss working group on presurgical epilepsy diagnosis and operative epilepsy treatment. Epilepsia 57(8):1215\u20131220. https:\/\/doi.org\/10.1111\/epi.13449","journal-title":"Epilepsia"},{"issue":"4","key":"10065_CR14","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1111\/epi.13709","volume":"58","author":"IE Scheffer","year":"2017","unstructured":"Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, Hirsch E, Jain S, Mathern GW, Moshe SL, Nordli DR, Perucca E, Tomson T, Wiebe S, Zhang YH, Zuberi SM (2017) ILAE classification of the epilepsies: position paper of the ILAE commission for classification and terminology. Epilepsia 58(4):512\u2013521. https:\/\/doi.org\/10.1111\/epi.13709","journal-title":"Epilepsia"},{"issue":"1","key":"10065_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1684\/epd.2019.1033","volume":"21","author":"H L\u00fcders","year":"2019","unstructured":"L\u00fcders H, Vaca GF, Akamatsu N, Amina S, Arzimanoglou A, Baumgartner C, Benbadis SR, Bleasel A, Bermeo-Ovalle A, Bozorgi A, Carreno M, Devereaux M, Francione S, Losarcos NG, Hamer H, Holthausen H, Jamal-Omidi S, Kalamangalam G, Kanner AM, Knake S, Lacuey N, Lhatoo S, Lim SH, Londono LV, Mani J, Matsumoto R, Miller JP, Noachtar S, Palmini A, Park J, Rosenow F, Shahid A, Schuele S, Steinhoff BJ, Akos Szabo C, Tandon N, Terada K, Boas WVE, Widdess-Walsh P, Kahane P (2019) Classification of paroxysmal events and the four-dimensional epilepsy classification system. Epileptic Disord 21(1):1\u201329. https:\/\/doi.org\/10.1684\/epd.2019.1033","journal-title":"Epileptic Disord"},{"issue":"8","key":"10065_CR16","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1212\/WNL.44.8.1403","volume":"44","author":"WH Theodore","year":"1994","unstructured":"Theodore WH, Porter RJ, Albert P, Kelley K, Bromfield E, Devinsky O, Sato S (1994) The secondarily generalized tonic-clonic seizure: a videotape analysis. Neurology 44(8):1403\u20131407","journal-title":"Neurology"},{"key":"10065_CR17","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.seizure.2020.03.008","volume":"78","author":"J Shum","year":"2020","unstructured":"Shum J, Fogarty A, Dugan P, Holmes MG, Leeman-Markowski BA, Liu AA, Fisher RS, Friedman D (2020) Sounds of seizures. Seizure 78:86\u201390. https:\/\/doi.org\/10.1016\/j.seizure.2020.03.008","journal-title":"Seizure"},{"key":"10065_CR18","doi-asserted-by":"publisher","first-page":"712","DOI":"10.3389\/fneur.2017.00712","volume":"8","author":"A Strzelczyk","year":"2017","unstructured":"Strzelczyk A, Griebel C, Lux W, Rosenow F, Reese JP (2017) The burden of severely drug-refractory epilepsy: a comparative longitudinal evaluation of mortality, morbidity, resource use, and cost using german health insurance data. Front Neurol 8:712. https:\/\/doi.org\/10.3389\/fneur.2017.00712","journal-title":"Front Neurol"},{"key":"10065_CR19","doi-asserted-by":"publisher","first-page":"414","DOI":"10.3389\/fneur.2018.00414","volume":"9","author":"LM Willems","year":"2018","unstructured":"Willems LM, Watermann N, Richter S, Kay L, Hermsen AM, Knake S, Rosenow F, Strzelczyk A (2018) Incidence, risk factors and consequences of epilepsy-related injuries and accidents: a retrospective single center study. Front Neurol 9:414. https:\/\/doi.org\/10.3389\/fneur.2018.00414","journal-title":"Front Neurol"},{"key":"10065_CR20","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.seizure.2015.02.031","volume":"27","author":"C Camfield","year":"2015","unstructured":"Camfield C, Camfield P (2015) Injuries from seizures are a serious, persistent problem in childhood onset epilepsy: a population-based study. Seizure 27:80\u201383. https:\/\/doi.org\/10.1016\/j.seizure.2015.02.031","journal-title":"Seizure"},{"issue":"9","key":"10065_CR21","doi-asserted-by":"publisher","first-page":"1565","DOI":"10.1212\/01.WNL.0000142991.14507.B5","volume":"63","author":"ND Lawn","year":"2004","unstructured":"Lawn ND, Bamlet WR, Radhakrishnan K, O'Brien PC, So EL (2004) Injuries due to seizures in persons with epilepsy: a population-based study. Neurology 63(9):1565\u20131570","journal-title":"Neurology"},{"issue":"6","key":"10065_CR22","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1212\/wnl.39.6.858","volume":"39","author":"PF Finelli","year":"1989","unstructured":"Finelli PF, Cardi JK (1989) Seizure as a cause of fracture. Neurology 39(6):858\u2013860. https:\/\/doi.org\/10.1212\/wnl.39.6.858","journal-title":"Neurology"},{"issue":"5","key":"10065_CR23","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1111\/epi.14738","volume":"60","author":"P Grzonka","year":"2019","unstructured":"Grzonka P, Rybitschka A, De Marchis GM, Marsch S, Sutter R (2019) Bone fractures from generalized convulsive seizures and status epilepticus-a systematic review. Epilepsia 60(5):996\u20131004. https:\/\/doi.org\/10.1111\/epi.14738","journal-title":"Epilepsia"},{"key":"10065_CR24","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.yebeh.2015.05.026","volume":"48","author":"SD Spritzer","year":"2015","unstructured":"Spritzer SD, Riordan KC, Berry J, Corbett BM, Gerke JK, Hoerth MT, Crepeau AZ, Drazkowski JF, Sirven JI, Noe KH (2015) Fall prevention and bathroom safety in the epilepsy monitoring unit. Epilepsy Behav 48:75\u201378. https:\/\/doi.org\/10.1016\/j.yebeh.2015.05.026","journal-title":"Epilepsy Behav"},{"key":"10065_CR25","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.yebeh.2014.01.021","volume":"33","author":"KM Sauro","year":"2014","unstructured":"Sauro KM, Macrodimitris S, Krassman C, Wiebe S, Pillay N, Federico P, Murphy W, Jette N, Epilepsy Monitoring Unit Quality Improvement T (2014) Quality indicators in an epilepsy monitoring unit. Epilepsy Behav 33:7\u201311. https:\/\/doi.org\/10.1016\/j.yebeh.2014.01.021","journal-title":"Epilepsy Behav"},{"issue":"1","key":"10065_CR26","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.nrl.2013.03.008","volume":"29","author":"M Ley","year":"2014","unstructured":"Ley M, Vivanco R, Massot A, Jimenez J, Roquer J, Rocamora R (2014) Safety study of long-term video-electroencephalogram monitoring. Neurologia (Barcelona, Spain) 29(1):21\u201326. https:\/\/doi.org\/10.1016\/j.nrl.2013.03.008","journal-title":"Neurologia (Barcelona, Spain)"},{"key":"10065_CR27","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.yebeh.2016.06.002","volume":"61","author":"F Fahoum","year":"2016","unstructured":"Fahoum F, Omer N, Kipervasser S, Bar-Adon T, Neufeld M (2016) Safety in the epilepsy monitoring unit: a retrospective study of 524 consecutive admissions. Epilepsy Behav 61:162\u2013167. https:\/\/doi.org\/10.1016\/j.yebeh.2016.06.002","journal-title":"Epilepsy Behav"},{"key":"10065_CR28","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.seizure.2017.05.006","volume":"49","author":"L Craciun","year":"2017","unstructured":"Craciun L, Alving J, Gardella E, Terney D, Meritam P, Cacic Hribljan M, Beniczky S (2017) Do patients need to stay in bed all day in the epilepsy monitoring unit? Safety data from a non-restrictive setting. Seizure 49:13\u201316. https:\/\/doi.org\/10.1016\/j.seizure.2017.05.006","journal-title":"Seizure"},{"issue":"1","key":"10065_CR29","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/CCM.0000000000002843","volume":"46","author":"R Sutter","year":"2018","unstructured":"Sutter R, Dittrich T, Semmlack S, Ruegg S, Marsch S, Kaplan PW (2018) Acute systemic complications of convulsive status epilepticus-a systematic review. Crit Care Med 46(1):138\u2013145. https:\/\/doi.org\/10.1097\/CCM.0000000000002843","journal-title":"Crit Care Med"},{"issue":"6","key":"10065_CR30","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1007\/s00256-012-1551-x","volume":"42","author":"S Winklhofer","year":"2013","unstructured":"Winklhofer S, Thekkumthala-Sommer M, Schmidt D, Rufibach K, Werner CM, Wanner GA, Alkadhi H, Hodler J, Andreisek G (2013) Magnetic resonance imaging frequently changes classification of acute traumatic thoracolumbar spine injuries. Skeletal Radiol 42(6):779\u2013786. https:\/\/doi.org\/10.1007\/s00256-012-1551-x","journal-title":"Skeletal Radiol"},{"issue":"3","key":"10065_CR31","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1007\/s00068-018-1030-8","volume":"45","author":"RD Verboket","year":"2019","unstructured":"Verboket RD, Sohling N, Marzi I, Paule E, Knake S, Rosenow F, Strzelczyk A, Willems LM (2019) Prevalence, risk factors and therapeutic aspects of injuries and accidents in women with epilepsy. Eur J Trauma Emerg Surg 45(3):375\u2013381. https:\/\/doi.org\/10.1007\/s00068-018-1030-8","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"10169","key":"10065_CR32","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/S0140-6736(18)32112-3","volume":"393","author":"JE Compston","year":"2019","unstructured":"Compston JE, McClung MR, Leslie WD (2019) Osteoporosis. Lancet 393(10169):364\u2013376. https:\/\/doi.org\/10.1016\/S0140-6736(18)32112-3","journal-title":"Lancet"},{"issue":"Pt A","key":"10065_CR33","doi-asserted-by":"publisher","first-page":"106511","DOI":"10.1016\/j.yebeh.2019.106511","volume":"100","author":"SS Diemar","year":"2019","unstructured":"Diemar SS, Sejling AS, Eiken P, Andersen NB, Jorgensen NR (2019) An explorative literature review of the multifactorial causes of osteoporosis in epilepsy. Epilepsy Behav 100(Pt A):106511. https:\/\/doi.org\/10.1016\/j.yebeh.2019.106511","journal-title":"Epilepsy Behav"},{"issue":"3","key":"10065_CR34","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.eplepsyres.2013.06.020","volume":"106","author":"S Bauer","year":"2013","unstructured":"Bauer S, Hofbauer LC, Rauner M, Strzelczyk A, Kellinghaus C, Hallmeyer-Elgner S, Oertel WH, Rosenow F (2013) Early detection of bone metabolism changes under different antiepileptic drugs (ED-BoM-AED)\u2013a prospective multicenter study. Epilepsy Res 106(3):417\u2013422. https:\/\/doi.org\/10.1016\/j.eplepsyres.2013.06.020","journal-title":"Epilepsy Res"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-020-10065-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-020-10065-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-020-10065-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T00:10:09Z","timestamp":1625875809000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-020-10065-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,10]]},"references-count":34,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10065"],"URL":"https:\/\/doi.org\/10.1007\/s00415-020-10065-5","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,10]]},"assertion":[{"value":"7 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2020","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2020","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2020","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"JP Z\u00f6llner reports speaker\u2019s honoraria from Desitin Arzneimittel and Eisai, outside the submitted work. S Knake reports honoraria for speaking engagements from Desitin and UCB Pharma as well as educational grants from AD Tech, Desitin Arzneimittel, Eisai, GW Pharmaceuticals, Medtronic, Novartis, Siemens, and UCB Pharma. L Kay reports honoraria from Desitin Arzneimittel and non-financial support from Eisai and UCB Pharma, outside the submitted work. S Schubert-Bast reports personal fees from UCB Pharma, Eisai, Desitin Pharma, GW Pharmaceuticals, LivaNova, and Zogenix, outside the submitted work. F Rosenow reports personal fees from Arvell Therapeutics, Desitin, Eisai, GW Pharmaceuticals, Medtronic, Novartis, UCB Pharma, Shire, grants from the European Union, the German Ministry for Education and Research, the State of Hessen, the Deutsche Forschungsgemeinschaft and the Detlev-Wroble-Fonds for Epilepsy Research outside the submitted work. A Strzelczyk reports personal fees and grants from Arvelle Therapeutics, Desitin Arzneimittel, Eisai, GW Pharmaceuticals, LivaNova, Marinus Pharmaceuticals, Medtronic, Sage Therapeutics, UCB Pharma, and Zogenix, outside the submitted work. None of the other authors reports conflicts of interest related to this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study was approved by the appropriate ethics committees in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Informed consent was waived by the ethics committees due to the retrospective nature of this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}