Restraining patients and shoulder dislocations during seizures

We describe 3 patients whose shoulders dislocated as the movements of the a rm were restricted during a generalized tonic clonic seizure over an 18-mon th period. The first patient had both shoulders dislocated when observers s at on his arms during the convulsion. The second patient had a convulsion w hile in a forced lateral decubitus position and dislocated the shoulder on that side. The third patient dislocated the shoulder and fractured the acro mion as she was held by her arms in a chair during a convulsion. Despite th e large number of patients with refractory epilepsy under our care, no case s of spontaneous shoulder dislocation occurred during that period of time.