Bilateral Proximal Humeral Fractures after a Generalized Tonic-Clonic Seizure-A Case Report

Simultaneous bilateral proximal humeral fractures are rarely seen in clinical practice. We report a case of this type of fracture in a middle-aged woman with a history of affective disorder with major depression dependent on high-dose benzodiazepine for control. Her fractures occurred just after a tonic-clonic seizure attack without major traumatic injury possibly caused by benzodiazepine withdrawal. Therefore, we originally suspected that her fractures might have been pathological. However, later studies including dual X-ray absorptiometry and whole-body bone scan were negative for pathological fracture. The simultaneous bilateral proximal humeral fractures were probably caused by the strong muscular pull and tetanic muscular contraction of the upper extremities in seizure attack. We emphasize the importance of suspecting bilateral proximal humeral fracture in patients with shoulder pain after a seizure attack.