Anterior Shoulder Dislocation after Epileptic Seizures

A known epileptic in his twenties came in with complaints of fainting (with epileptic seizure) and sustaining a left shoulder stifness and severe pain upon 'waking-up'. There was a bulge in front of his left shoulder and a small depression (sulcus sign) under the left acromion (see photo). He could not lift his left arm at all due to the pain and stiffness.

We iced his shoulder and gave him an analgesic injection for the severe pain. He was then referred to an Orthopaedic Surgeon for imaging and to reduce the dislocation since it was already several hours after the incident. If he is an athlete who requires vigorous upper limb strength and mobility, he has a high risk of recurrent shoulder dislocation and would usually need surgery.