Burn injuries in patients with epilepsy: A narrative review

Epilepsy is a chronic condition with a high risk of associated morbidity, including burn injuries, which can increase lifelong disability burden. People with epilepsy (PWE) can incur burns secondary to seizures, which often require prolonged care and can be life- or limb-threatening.

A focused literature search was conducted using MEDLINE, Scopus, and Web of Science (1947-September 2025), supplemented by citation searching. Studies reporting seizure-related burn mechanisms, injury patterns, and outcomes in PWE were included. Studies including patients with psychogenic non-epileptic seizures (PNES), were included only when differentiation from PWE was not feasible. Other exclusion criteria comprised non-English language, sample size < 10, or lack of epilepsy-specific burn focus.

21 studies encompassing 1515 patients were identified. 15/21 studies were from low-/middle-income countries (LMICs). Burns disproportionately affected young adults and women (average 58%). Across studies, scalds and flame burns emerged as the most frequent injury mechanisms, typically occurring during routine activities such as cooking or bathing. Generalised tonic-clonic was the most common seizure type implicated. Non-adherence to anti-seizure medication was frequently reported. Injuries were severe, with surgery including amputation required in many cases. Hospital stays ranged 5-69 days, with mortality reaching 40% in some cohorts.

Burn injuries amongst PWE represent a severe, preventable cause of disability. Burn mechanisms vary according to seizure type and setting. Gender roles, socioeconomic disparities, and cultural factors amplify risk, especially in LMICs. Multidisciplinary care and context-specific prevention strategies including patient education, practical safeguarding tools, and improved medication availability and adherence are essential.