抄録
Surgical treatment of recurrent anterior glenohumeral joint dislocation caused by epileptic seizures is more difficult than that of traumatic dislocation when the control of the epileptic seizures is poor. We report herein a case of recurrent anterior glenohumeral joint dislocation caused by uncontrolled epileptic seizures. An 18-year-old man with autism had developed epilepsy at the age of 10. Although he had been treated for epilepsy by various pharmacotherapies, his seizures were poorly controlled, occurring two to four times a month. The first anterior glenohumeral joint dislocation caused by an epileptic seizure occurred at the age of 15, and the frequency of dislocation increased gradually thereafter. Dislocation also began to occur in daily life even without seizures, and the patient was referred to our hospital. Slight limitation of range of motion and positive anterior apprehension sign on the left shoulder were observed. Computed tomography and magnetic resonance arthrography showed an inverted pear shaped glenoid representing a Bankart lesion with approximately 20% bone loss. A large Hill-Sachs lesion was also observed. Arthroscopic Bankart and mini-open Remplissage procedures were performed to repair the Bankart lesion with tenodesis of the infraspinatus tendon for the Hill-Sachs lesion. Although the patient experienced epileptic seizures 20 times during 10 months after surgery, dislocation did not occur. We conclude that arthroscopic Bankart and mini-open Remplissage procedures may be useful in cases of recurrent shoulder dislocation caused by uncontrolled epileptic seizures.
