Patients with Epilepsy: A High-Risk Population Prone to Severe Burns as a Consequence of Seizures While Showering

Abstract

We document the severe burns sustained by three patients with epilepsy who suffered seizures while showering. On the basis of the circumstances of these accidents, we suggest preventative measures to help other patients with epilepsy avoid similar burn injuries. Patient data collected from January 1987 to May 2004 by the Burn Unit of the Department of Plastic Surgery, University of Aachen, Germany, were reviewed. Three patients with epileptic disorders were found who suffered severe burn injuries caused by seizures that occurred while showering. Scald location and depth was assessed. Three patients (two women, one man) sustained extensive scald injuries after epileptic seizures while showering. Burn extent ranged from 20% to 35% TBSA. Scalds primarily affected the trunk, legs, arms, and buttocks. Two of the three patients used showers with levers for controlling water temperature. Safety devices for limiting water temperature were absent. All patients used shower cubicles. Patients with epilepsy may sustain serious burns, typically affecting the trunk, legs, arms, and buttocks, when a seizure occurs while showering. We suggest that individuals with epilepsy use showers designed with pirouetting taps, rather than levers, to regulate water temperature. Pirouetting taps are less likely to be shifted out of position during a seizure. We also recommend that epileptic patients have safety devices installed in their water heaters that limit maximum water temperature. Such safety devices prevent scald injury. And, finally, we suggest that people with comparable disorders generally avoid using shower cubicles. Instead, showers with curtains should be used, which may allow occupants to escape from dangerously hot shower water more easily.

Seizure related accidents and injuries in childhood

“…This may be due to the fact that seizure related burns usually occur while cooking or showering without supervision [13][14][15] . our data showed no difference between the risk of seizures in children with or without developmental delay or the ability to walk without assistance.…”

Predictive risk factors of seizure-related injury in persons with epilepsy

“…Seizure-related injuries (SRI) are common and reported with a wide range of events. It can be just minor trauma to intracranial hematoma [2], extensive severe burns [3] or even death [4].…”

Impact of para-neurologic and para-mental premorbidities on burn injury patients

“…[17,18] In the literature, 42% of injuries are associated with cooking, which is also more common among females because of their domestic responsibilities. [19][20][21] In most of our cases, the injuries occurred during bathing. Use of different types of boilers is common in Turkey.…”

“…A scalding injury is more likely when the water is warmer than 43 °C. [21] Safety devices that limit the water temperature are recommended. In the homes of pediatric premorbid patients, water heaters should be set at 37.7 °C (100 °F); in the case of other adults, these devices can be set to 48.8-51.6 °C (120-125 °F).…”