Epilepsy-Related Fall Leading to Cervical Myelopathy and Depressive Adjustment Disorder: A Case Report

Abstract

Background: Cervical spinal cord injury (SCI) represents a severe neurological emergency that can lead to long-term disability. In patients with uncontrolled epilepsy, seizure-related falls significantly increase the risk of traumatic SCI. Beyond physical sequelae, such cases frequently involve complex psychological consequences, including adjustment disorders and depressive reactions, which warrant multidisciplinary management.

Case Presentation: We report the case of a 50-year-old male with a longstanding history of epilepsy who presented with tetraparesis following a seizure-related fall. Magnetic resonance imaging revealed cervical spinal cord edema, multilevel disc herniations, and degenerative changes. Electroencephalography indicated left temporal epileptogenic dysfunction with mild diffuse encephalopathy. The patient underwent decompressive laminoplasty, resulting in partial motor recovery. He was diagnosed with adjustment disorder with depressive reaction according to ICD-10/PPDGJ-III criteria. Seizure control and psychiatric symptoms improved with antiepileptic and anxiolytic pharmacotherapy.

Conclusion: This case highlights the interplay between epilepsy, neurological trauma, and psychological comorbidities. Patients with uncontrolled seizures face an elevated risk of severe secondary injuries that can lead to complex physical and psychological sequelae. Comprehensive management—including surgical intervention, consistent antiseizure therapy, and psychological support—is essential to optimize recovery and quality of life.