Bilateral Anterior Shoulder Dislocations Following a Clozapine-Induced Seizure

Abstract

Posterior shoulder dislocations are a recognised complication of generalised seizure episodes. Although less frequent, anterior shoulder dislocations are now being acknowledged as an emerging consequence. Particularly when they occur bilaterally, they can contribute to diagnosing a seizure disorder in a patient who shows no other signs during the post-ictal period. This article presents a case of bilateral anterior shoulder dislocations in an otherwise physically healthy young Sudanese gentleman following a generalised seizure episode on clozapine for a schizoaffective disorder. The case aims to raise awareness of the occurrence of this phenomenon and emphasises the importance of timely diagnostic testing, seizure prophylaxis, and follow-up to minimise the risk of further seizure episodes and potential consequences. Additionally, there is a discussion regarding the utility of monitoring clozapine concentrations.

Keywords: bilateral anterior shoulder dislocation; clozapine side effects; risk of seizure; seizure triggers; therapeutic drug monitoring.