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Microwave oven injuries in patients with complex partial seizures
Epilepsy & Behavior Epilepsy & Behavior 5 (2004) 772–774 www.elsevier.com/locate/yebeh
Brief Communication
Microwave oven injuries in patients with complex partial seizures John C. DeToledo* and Merredith R. Lowe Department of Neurology, University of Miami School of Medicine, Miami, FL 33136, USA Received 29 March 2004; revised 26 May 2004; accepted 27 May 2004 Available online 10 July 2004
Abstract Microwave ovens are often recommended as a safe cooking alternative for persons with epilepsy. We report four patients who suffered serious burns to their hands while handling microwave-heated liquids during a complex partial seizure (CPS). Injuries were due to the contact of the skin with a very hot container. The fact that all patients held on to the hot containers despite being burned and that they did not remember experiencing any pain at the time of the accident indicates that neither high temperatures nor pain will prevent patients who are having a CPS from suffering this type of injury. Unfortunately, there is no foolproof way to prevent the individual from opening the oven and removing its contents during a CPS. The only solution for this problem is ‘‘prevention’’—individuals with poorly controlled CPS should be cautioned about these risks. The use of microwave settings that permit the heating but not boiling of liquids and the use of gloves while heating food and liquids to scalding temperatures may minimize the risk of this type of injury. Ó 2004 Elsevier Inc. All rights reserved. Keywords: Seizures; Epilepsy; Injuries; Burn; Microwave; Accident
1. Introduction Microwave ovens brought a new freedom to patients with poorly controlled seizures who were previously advised not to use conventional ovens or stoves. Whereas microwave ovens are generally safe, the fact that one can suffer serious burns while handling food and liquids heated this way is not always appreciated.
2. Case reports We report four patients with incompletely controlled seizures who suffered burns on the hands from handling microwave-heated containers during a complex partial seizure (Table 1). These four patients had a several-year history of poorly controlled partial seizures and had been advised to avoid using conventional stoves for that reason. Two of them already had suffered cooking-re*
Corresponding author. Fax: 1-305-243-7668. E-mail address: [email protected] (J.C. DeToledo). 1525-5050/$ - see front matter Ó 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.yebeh.2004.05.009
lated burns with conventional ovens prior to their microwave burns. None of the four patients remembered the circumstances of the present accident nor remembered the initial pain. Three patients suffered contact burns to the palm of the hand and fingers but did not spill the contents during the seizure. They seemed to have held on to the containers for several moments despite the high temperature and the burn (Fig. 1). Despite the relatively severe burns, only one patient spilled the hot contents of the container. She was heating the water for a cup of tea. Although the circumstances in which this injury took place were not clear, the multiple small lesions in the forearm suggest that the patient was scalded by a ‘‘shower’’ of very hot water as she placed the teabag into the cup.
3. Discussion Microwave ovens are safer than the traditional stove, but can still pose a risk in situations where the user either does not know (i.e., children) or has lost awareness
Brief Communication / Epilepsy & Behavior 5 (2004) 772–774
773
Table 1 Demographics of four patients with poorly controlled complex partial seizures who suffered contact burns after handling microwave oven-heated containers Age/gender
Seizure type/frequency
History of seizures (years)
Previous burns
Area of injury
Memory for the accident
38/male 50/female 41/male 27/female
2 CPSa /month 6–8 CPS/month 3 or 4 CPS/year 1 or 2 CPS/month
21 18 12 6
No Yes Yes No
Hand Hand/forearm Hand Hand
No No No No
a
Complex partial seizure.
Fig. 1. Contact burn to the palm of the hand and fingers after handling a hot microwave-heated container during a complex partial seizure.
Table 2 Microwave oven activities with a high risk of resulting in thermal injuries Boiling plain water Using a clean shiny container (mug or Pyrex) Boiling more than once Cooking for extra long periods (stores more energy, higher risk for overheating) Removing container immediately (no chance to cool down) Dumping any powder into the water (sugar, creamer, teabag, etc.) Source. Reproduced, with permission, from the Center for Devices and Radiological Health Consumer Information [1].
(i.e., complex partial seizure) about the basic safe operation of these devices (Table 2). Burning by contact is the most common type of microwave-related thermal injuries [2–4]. That is followed by burns caused by bursts of steam and bubbles. This type of injury occurs when liquids (i.e., water) are heated in open containers with a microwave oven. When water overheats in a conventional oven, bubbles rise from the bottom, and as they burst at the surface, the excess heat is dissipated. Water heated with a microwave oven usually does not bubble. In the absence of bubbling, the water is
not cooled and the temperature may rise well above 100 °C [5,6]. If a powder is poured into this overheated water (i.e., sugar, salt, tea), tiny air bubbles are carried into the water. Each of these bubbles expands into a larger steam bubbles and can result in a ‘‘burst’’ of hot froth. This is what seems to have happened to patient 2. The burns in these 4 patients involved the palm of the hand and fingers indicating that the injury was due to contact of the skin with a very hot container. The fact that all these patients held on to the hot containers despite being burned by the containers and that they did not remember experiencing any pain at the time of the accident indicates that neither high temperatures nor pain will prevent patients who are having a complex partial seizure from suffering this type of injury. Unfortunately there is no foolproof way to prevent an individual from opening the oven and removing its contents during a complex partial seizure. The only solution for this problem is ‘‘prevention’’: individuals with poorly controlled complex partial seizures should be cautioned about these risks. The use of microwave settings that permit the heating but not boiling of liquids and the use of gloves while heating food and liquids to
774
Brief Communication / Epilepsy & Behavior 5 (2004) 772–774
scalding temperatures may minimize the risk of this type of injury. In addition, patients with poorly controlled complex partial seizures should determine whether their dishes and cups are safe for microwave use. A dish that becomes hot absorbs more energy and is more likely to cause contact burns.
References [1]
Center for Devices and Radiological Health Consumer Information. http://www.fda.gov/cdrh/consumer/microwave.html#10.
[2]
[3]
[4]
[5]
[6]
Nahlieli O, Eliav E, Shapira Y, Baruchin AM. Central palatal burns associated with the eating of microwaved pizzas. Burns 1999;25:465–6. Weiner GM, O’Connell JE. Oropharyngeal burns from microwave ovens: case report and review of the literature. J Otolaryngol 1995;24:368–9. Ford GR, Horrocks CL. Hazards of microwave cooking: direct thermal damage to the pharynx and larynx. J Laryngol Otol 1994;108:509–10. Eiseman AS, Maus M, Flanagan JC. Second-degree eyelid burn after use of microwave-heated compress. Ophthalmol Plast Reconstruct Surg 2000;16:304–5. Nurse ‘microwaves washcloth’ for infant: nurse is liable for second degree burns. Nurs Law Regan Rep 2000;40(11):3.
Brief Communication
Microwave oven injuries in patients with complex partial seizures John C. DeToledo* and Merredith R. Lowe Department of Neurology, University of Miami School of Medicine, Miami, FL 33136, USA Received 29 March 2004; revised 26 May 2004; accepted 27 May 2004 Available online 10 July 2004
Abstract Microwave ovens are often recommended as a safe cooking alternative for persons with epilepsy. We report four patients who suffered serious burns to their hands while handling microwave-heated liquids during a complex partial seizure (CPS). Injuries were due to the contact of the skin with a very hot container. The fact that all patients held on to the hot containers despite being burned and that they did not remember experiencing any pain at the time of the accident indicates that neither high temperatures nor pain will prevent patients who are having a CPS from suffering this type of injury. Unfortunately, there is no foolproof way to prevent the individual from opening the oven and removing its contents during a CPS. The only solution for this problem is ‘‘prevention’’—individuals with poorly controlled CPS should be cautioned about these risks. The use of microwave settings that permit the heating but not boiling of liquids and the use of gloves while heating food and liquids to scalding temperatures may minimize the risk of this type of injury. Ó 2004 Elsevier Inc. All rights reserved. Keywords: Seizures; Epilepsy; Injuries; Burn; Microwave; Accident
1. Introduction Microwave ovens brought a new freedom to patients with poorly controlled seizures who were previously advised not to use conventional ovens or stoves. Whereas microwave ovens are generally safe, the fact that one can suffer serious burns while handling food and liquids heated this way is not always appreciated.
2. Case reports We report four patients with incompletely controlled seizures who suffered burns on the hands from handling microwave-heated containers during a complex partial seizure (Table 1). These four patients had a several-year history of poorly controlled partial seizures and had been advised to avoid using conventional stoves for that reason. Two of them already had suffered cooking-re*
Corresponding author. Fax: 1-305-243-7668. E-mail address: [email protected] (J.C. DeToledo). 1525-5050/$ - see front matter Ó 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.yebeh.2004.05.009
lated burns with conventional ovens prior to their microwave burns. None of the four patients remembered the circumstances of the present accident nor remembered the initial pain. Three patients suffered contact burns to the palm of the hand and fingers but did not spill the contents during the seizure. They seemed to have held on to the containers for several moments despite the high temperature and the burn (Fig. 1). Despite the relatively severe burns, only one patient spilled the hot contents of the container. She was heating the water for a cup of tea. Although the circumstances in which this injury took place were not clear, the multiple small lesions in the forearm suggest that the patient was scalded by a ‘‘shower’’ of very hot water as she placed the teabag into the cup.
3. Discussion Microwave ovens are safer than the traditional stove, but can still pose a risk in situations where the user either does not know (i.e., children) or has lost awareness
Brief Communication / Epilepsy & Behavior 5 (2004) 772–774
773
Table 1 Demographics of four patients with poorly controlled complex partial seizures who suffered contact burns after handling microwave oven-heated containers Age/gender
Seizure type/frequency
History of seizures (years)
Previous burns
Area of injury
Memory for the accident
38/male 50/female 41/male 27/female
2 CPSa /month 6–8 CPS/month 3 or 4 CPS/year 1 or 2 CPS/month
21 18 12 6
No Yes Yes No
Hand Hand/forearm Hand Hand
No No No No
a
Complex partial seizure.
Fig. 1. Contact burn to the palm of the hand and fingers after handling a hot microwave-heated container during a complex partial seizure.
Table 2 Microwave oven activities with a high risk of resulting in thermal injuries Boiling plain water Using a clean shiny container (mug or Pyrex) Boiling more than once Cooking for extra long periods (stores more energy, higher risk for overheating) Removing container immediately (no chance to cool down) Dumping any powder into the water (sugar, creamer, teabag, etc.) Source. Reproduced, with permission, from the Center for Devices and Radiological Health Consumer Information [1].
(i.e., complex partial seizure) about the basic safe operation of these devices (Table 2). Burning by contact is the most common type of microwave-related thermal injuries [2–4]. That is followed by burns caused by bursts of steam and bubbles. This type of injury occurs when liquids (i.e., water) are heated in open containers with a microwave oven. When water overheats in a conventional oven, bubbles rise from the bottom, and as they burst at the surface, the excess heat is dissipated. Water heated with a microwave oven usually does not bubble. In the absence of bubbling, the water is
not cooled and the temperature may rise well above 100 °C [5,6]. If a powder is poured into this overheated water (i.e., sugar, salt, tea), tiny air bubbles are carried into the water. Each of these bubbles expands into a larger steam bubbles and can result in a ‘‘burst’’ of hot froth. This is what seems to have happened to patient 2. The burns in these 4 patients involved the palm of the hand and fingers indicating that the injury was due to contact of the skin with a very hot container. The fact that all these patients held on to the hot containers despite being burned by the containers and that they did not remember experiencing any pain at the time of the accident indicates that neither high temperatures nor pain will prevent patients who are having a complex partial seizure from suffering this type of injury. Unfortunately there is no foolproof way to prevent an individual from opening the oven and removing its contents during a complex partial seizure. The only solution for this problem is ‘‘prevention’’: individuals with poorly controlled complex partial seizures should be cautioned about these risks. The use of microwave settings that permit the heating but not boiling of liquids and the use of gloves while heating food and liquids to
774
Brief Communication / Epilepsy & Behavior 5 (2004) 772–774
scalding temperatures may minimize the risk of this type of injury. In addition, patients with poorly controlled complex partial seizures should determine whether their dishes and cups are safe for microwave use. A dish that becomes hot absorbs more energy and is more likely to cause contact burns.
References [1]
Center for Devices and Radiological Health Consumer Information. http://www.fda.gov/cdrh/consumer/microwave.html#10.
[2]
[3]
[4]
[5]
[6]
Nahlieli O, Eliav E, Shapira Y, Baruchin AM. Central palatal burns associated with the eating of microwaved pizzas. Burns 1999;25:465–6. Weiner GM, O’Connell JE. Oropharyngeal burns from microwave ovens: case report and review of the literature. J Otolaryngol 1995;24:368–9. Ford GR, Horrocks CL. Hazards of microwave cooking: direct thermal damage to the pharynx and larynx. J Laryngol Otol 1994;108:509–10. Eiseman AS, Maus M, Flanagan JC. Second-degree eyelid burn after use of microwave-heated compress. Ophthalmol Plast Reconstruct Surg 2000;16:304–5. Nurse ‘microwaves washcloth’ for infant: nurse is liable for second degree burns. Nurs Law Regan Rep 2000;40(11):3.