Aust M, Guggenheim M, Gohritz A, Künzi W, Handschin A, Vogt P, Giovanoli P
Klinik für Wiederherstellungschirurgie, Universitätsspital Zürich, Schweiz.
Handchir Mikrochir Plast Chir. 2008 Dec;40(6):372-6. doi: 10.1055/s-2008-1039002. Epub 2008 Nov 14.
Burn injuries are a serious threat to individuals with altered consciousness during epilepsy. The objective of this study detailing 33 individuals who sustained scalds or burn injuries during an epileptic seizure, was to clarify typical injury mechanisms, extent, therapy and sequelae of these injuries and thus identify potential preventive measures to protect this special population from thermal trauma.
Overall, 16 women and 17 men with a mean age of 39.6 (range: 21 - 76) years were included in this retrospective review. The burned body area averaged 16 % (maximum: 51 %), 30 of the 33 patients (91 %) required burn wound excision and skin grafting. The mean ABSI score was 5.5 (range: 3 to 11) points. Thermal trauma mostly occurred as hot water scalds (n = 19) during showering or bathing in a tub (n = 15), followed by falls during cooking or into open fire. None of our patients was informed about the risk of experiencing severe thermal injuries during epileptic seizures. The length of intensive care averaged 33 days (maximum: 79 days), all patients survived. The estimated treatment costs were at least 50,000 Euros per patient.
In conclusion, epileptic seizures can cause severe and deep thermal trauma. Our data shows that most of these injuries happen at home and may be easily prevented by simple safety devices, such as water thermo-regulators or the avoidance of high-risk situations, it seems advisable to inform patients with epilepsy and their families and care-givers of this specific danger.
烧伤对癫痫发作时意识改变的个体构成严重威胁。本研究详细描述了33例在癫痫发作期间遭受烫伤或烧伤的患者，目的是阐明这些损伤的典型损伤机制、程度、治疗方法和后遗症，从而确定潜在的预防措施，以保护这一特殊人群免受热创伤。
在这项回顾性研究中，共纳入了16名女性和17名男性，平均年龄为39.6岁（范围：21 - 76岁）。烧伤面积平均为16%（最大为51%），33例患者中有30例（91%）需要进行烧伤创面切除和皮肤移植。平均ABSI评分为5.5分（范围：3至11分）。热创伤主要发生在淋浴或浴缸洗澡时的热水烫伤（n = 19），其次是烹饪时摔倒或跌入明火。我们的患者均未被告知癫痫发作期间发生严重热损伤的风险。重症监护的平均时长为33天（最长为79天），所有患者均存活。估计每位患者的治疗费用至少为50,000欧元。
总之，癫痫发作可导致严重的深度热创伤。我们的数据表明，这些损伤大多发生在家中，通过简单的安全装置，如水温调节器或避免高风险情况，可能很容易预防。告知癫痫患者及其家人和护理人员这种特殊危险似乎是明智的。
