Epilepsy precipitated by hot water immersion

Reflex-Epilepsy Induced by Immersion in Hot Water

“…« * _ \ r. i ( fp2-f4 f4 -c4 c4 -p4 p4 -o2 fpl -f3 f3 -c3 c3 -p3 p3 -o l fp2 -f 8 f8 -t4 t4 -t6 t6 -o2 fpl -f7 il -t3 t3 -t5 t5 -ol which a seizure can be elicited. Some patients did not get a seizure with water temperature below 45 °C [4,5], In our patient, and the patient of Stensman and Ursing [11], no seizures occurred below a water temperature of 40 °C. In 9 patients seizures could be elicited by either hot water or by cold water [4], but in none by cold water alone.…”

“…In this patient the interictal EEG showed abnormal theta activity and high voltage waves. Interic tal electro-encephalography revealed abnormalities in a minority of cases [5,7,12] and then only when other types of epilepsy were present [5,7] [11] and slow waves originat ing in the left hemisphere [8], The fifth ictal recording showed an increase in frequency of pre-existent bilateral spikes [7], Our patient showed delta waves with a right sided initial dominance with an immediate generaliza tion.…”

Hot Water Epilepsy: Presentation of Three Cases

“…The largest case series in the literature was reported from Turkey and India, but the number of reported cases is still low (2). The definite pathophysiology of HWE is not known but these patients are thought to have an abnormal thermoregulation system with the seizures emerging due to the stimulation of a particular region in the brain cortex through contact of head skin with hot water (6). The cause of this abnormal thermoregulation system is thought to be an autosomal recessive hereditary predisposition; this hypothesis has been supported by autopsy studies (7,8).…”

Hot-water epilepsy: a new Caucasian case

“…Seizures provoked by contact with hot water during bathing, known as hot-water epilepsy, water-immersion epilepsy or bathing epilepsy, is a benign type of reflex epilepsy rarely seen in western countries [3,4,6], but more common in Turkey [1,2] and India [5]. Hot-water epilepsy is mostly seen in infants and children [1,2,3,4,5] with a male:female ratio of 2-3:1 [1,2,3,4,5].…”

“…About 33% are primarily generalised, usually tonicclonic [5]. Seizures may start with a sense of fear or wellbeing, vertigo, activity arrest, confused speech, visual and auditory hallucinations, or complex automatisms [1,5,6]. Further symptoms include decrease or loss of consciousness, hypotonia or hypertonia, staring, rolling of the eyeballs, twitching facial muscles, focal convulsions, tonic-clonic convulsions and cyanosis [3,4,6].…”