The authors describe a prospective study on seizure-related injuries in Norway's two nursing homes for persons with epilepsy. 62 multihandicapped patients, most of them with a form of epilepsy that is difficult to treat, were assessed for 13 months. A total of 6,889 seizures, 2,696 with ensuing falls, resulted in 80 injuries. This gives a seizure-related injury risk of 1.2%. Only six serious injuries were recorded. The types of seizures most often causing the injuries were atonic and tonic-clonic seizures. Prophylactic measures are discussed. Since the risk of injury was found to be small, we conclude that even people with refractory epilepsy should be encouraged to live active lives.