Hot-water epilepsy: From bench to bedside

Satishchandra, P; Sinha, Sanjib

doi:10.4103/0972-2327.112442

Cited by 12 publications

(24 citation statements)

References 22 publications

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“…There was a similar outcome in both groups with a 72% seizure reduction in those with intermittent medication compared with 72% in those with continuous antiepileptics. 16 This method of intermittent prophylaxis may be challenging in cases where seizures are frequent due to regular bathing habits and if there is increased parental concern. In these cases, daily antiepileptic drugs may be used.…”

Section: Treatmentmentioning

confidence: 99%

Hot Water Epilepsy

2019

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Hot water epilepsy (HWE) is a type of reflex epilepsy in which seizures are precipitated by pouring water at a higher temperature during bathing onto the head or body. The etiology is still not known and is presumably both genetic and environmental. Focal seizures with impaired awareness are the most common seizure types and generalized tonic-clonic seizures are the second common type of seizures. The diagnosis is clinical. Interictal electroencephalography and neuroimaging are usually normal. Treatment consists of avoidance of the triggering factor. However, in cases where this option is not effective, antiepileptics can be used. Clobazam appears to be the most effective therapy, particularly for pure HWE. This is an up-to-date review of the literature.

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Section: Treatmentmentioning

confidence: 99%

Hot Water Epilepsy

2019

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“…8,[26][27][28]31 In reality, the triggering stimulus can range from pouring hot water overhead or immersion in hot water 13,26,28,35 to varying the heat of water, 26,28,31,36 recalling sensory experiences related to bathing, 26,31 and recalling past bathing experiences. 28 HWE is most commonly observed in children and young adults, with a rarer variant being seen in infants. There is a noted male-to-female ratio of approximately 3:1; however, the exact cause for the higher prevalence seen in males is not well understood.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…There is a noted male-to-female ratio of approximately 3:1; however, the exact cause for the higher prevalence seen in males is not well understood. 26,28,31 HWE onset has been reported to occur most frequently in adolescence or early adulthood. 26,28,31 In the infantile variant of HWE, however, the age of onset has been reported to occur in early infancy as early as 6 months of age.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…19 HWE was first described by Allen, 20 and over the years, rare case reports have emerged worldwide from the United States, 21 France, 11 Italy, 22 Japan, 23 Albania, 24 Saudi Arabia, 25 Brazil, 14 and Turkey 26 with most cases reported from southern India. 8,27,28 While variability exists regarding its presentation, HWE generally manifests in two variants: one form in adolescents and adults 8 and the other in infants. 29 The first form has been reported worldwide; however, most cases are found in southern India accounting for 3.6 to 3.9% of all epilepsies.…”

Section: Introductionmentioning

confidence: 99%

“…29 The first form has been reported worldwide; however, most cases are found in southern India accounting for 3.6 to 3.9% of all epilepsies. 28 This regionalization of HWE may be accounted for by cultural practices in India, such as head bathing and consanguineous marriages, as well as genetic predisposition. 8,[30][31][32] The second form is reported more in western patients who tend to be younger (< 12 months) and have seizures triggered by immersion into water around 37.5°C.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Exploring Pre- and Postoperative Profiles of Hot Water Epilepsy: Revisiting Pathogenic Mechanisms

Schraegle

Nussbaum

2017

J Pediatr Epilepsy

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Hot water epilepsy (HWE) refers to a rare form of reflex epilepsy precipitated by the stimulus of pouring hot water over the head or by bathing. Despite being most commonly seen in southern India, isolated HWE cases have surfaced in western countries. HWE classically manifests as simple or complex partial with temporal lobe semiology. About a quarter of patients show interictal EEG abnormalities, which mostly occur over the temporal lobes. HWE has two established variants that are typically benign. We present two cases where HWE preceded spontaneous seizures, which later progressed to pharmacoresistant epilepsy. These cases garner further evidence for a symptomatic variant of HWE. Additionally, clinical features of HWE are discussed and an updated model of pathogenesis incorporating self-inducement phenomenon is proposed.

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