Abstracts

Rationale: Although motor vehicle accident is usually the most often discussed topic in patients with epilepsy (Spudis et al., 1986), driving fatalities attributed to seizures are rare (Wirrell, 2006). Aside from injuries sustained from falls secondary to loss of consciousness, burn injuries appear to be the most preventable but often under-emphasized source of morbidity and mortality. The reason for the burn can be two-fold: Either as directly caused by a seizure, such as loss of consciousness with subsequent fall onto a hot object, or due to a symptomatology of epilepsy, such as interictal confusion or clumsiness, and dropping of hot objects onto self.Methods: The hospital burn unit database was queried for patients who had a diagnosis of epilepsy at the time of admission between January 2000 and December 2009 (n=1408). A retrospective review of the 114 epilepsy patient charts was performed and the predominant reason for the burn was categorized. These charts were then separated into two groups: seizure induced burn group (SIB) and non-seizure induced burn group (NSIB), and the number of injuries due to a particular reason counted and compared.Results: Patients with an epilepsy diagnosis on admission to the burn unit comprised 8% of the database, which is significantly higher (p<0.01, Fisher's exact test) than the estimated 0.5% - 2% of individuals with epilepsy in the general population. In the seizure induced burn group (n=21), 15 were on anti-epileptic drugs and 12 had sub-therapeutic levels when the injury occurred. Notably, 71% (n=15) of the burns occurred during activities of daily living; of these, 73% (n=11) were due to cooking. In the non-seizure induced burn group (n=76), 39% (n=30) occurred during activities of daily living. Of these, 63% (n=19) were cooking-related. Additionally, 20% (n=15) of the burns were directly the result of smoking. Conclusions: Morbidity and mortality due to burns is significant and a preventable source of injury among epilepsy patients. Although most were not the direct result of seizures, they were likely contributed by epilepsy and/or the side effects of anti-epileptic drugs. Specifically, injuries from cooking appeared to be a main cause among the Philadelphia population. In contrast to other cultures, males predominated in both the SIB group and the NSIB group. Also, smoking was responsible for a large proportion of burns. Finally, even in the NSIB group, some burns may still be due to unrecognized seizures. Therefore, burn prevention should be an important aspect of a comprehensive seizure safety education.