Ictal Video-Electroencephalography Findings in Bathing Seizures: Two New Cases and Review of the Literature

Mosquera-Gorostidi, Arantxa; Azcona-Ganuza, Gurutzi; Yoldi-Petri, María Eugenia; Gurtubay, I. García de; Aguilera-Albesa, Sergio

doi:10.1016/j.pediatrneurol.2019.04.017

Cited by 10 publications

(19 citation statements)

References 19 publications

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“…Clobazam and valproic acid were the most effective drugs. Ictal EEG recorded in two subjects showed rhythmic theta activity over the frontocentral/temporal regions in keeping with the previous reports 9,17 . Variable cognitive impairment was noticed in ten out of thirteen subjects.…”

Section: Phenotypic Spectrum Of Syn1-related Reflex Epilepsysupporting

confidence: 91%

Clinical and Genetic Features in Patients With Reflex Bathing Epilepsy

Accogli

Wiegand²,

Scala³

et al. 2021

Neurology

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Objective:To describe the clinical and genetic findings in a cohort of subjects with bathing epilepsy, a rare form of reflex epilepsy.Methods:We investigated by Sanger and targeted re-sequencing the SYN1 gene in 12 individuals from 10 different families presenting with seizures primarily triggered by bathing or showering. Additional twelve subjects with hot-water epilepsy were also screened.Results:In all families with bathing epilepsy we identified 8 distinct pathogenic or likely pathogenic variants and 2 variants of unknown significance in SYN1, nine of which are novel. Conversely, none of the subjects with hot-water epilepsy displayed SYN1 variants. In mutated subjects, seizures were typically triggered by showering or bathing regardless of the water temperature. Additional triggers included fingernail-clipping, hair-cutting, or watching someone take a shower. Non-provoked seizures and a variable degree of developmental delay were also common.Conclusion:bathing epilepsy is genetically distinct reflex epilepsy mainly caused by SYN1 mutations.

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Section: Phenotypic Spectrum Of Syn1-related Reflex Epilepsysupporting

confidence: 91%

Clinical and Genetic Features in Patients With Reflex Bathing Epilepsy

Accogli

Wiegand²,

Scala³

et al. 2021

Neurology

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“…Ictal video-EEG often reveals delta-theta high-amplitude focal waves involving temporal and adjacent regions, rapidly spreading to the ipsilateral hemisphere or generalizing. Interictal EEG is usually normal, with occasional focal slow waves during sleep recordings [3]. In our case, clinical features and EEG ictal findings were consistent with bathing epilepsy.…”

Section: Discussionsupporting

confidence: 74%

“…In two cases receiving pharmacological treatment, occasional non-provoked seizures occurred. Neurodevelopment was normal in all the reported cases [3].…”

Section: Discussionmentioning

confidence: 67%

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Bathing epilepsy: a video case report

Cappellari

Bulgaro

Bruschi

et al. 2021

Epileptic Disorders

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Bathing epilepsy is a rare form of reflex epilepsy triggered by bathing in room temperature water. It predominates in boys with a mean age of 15 months and its evolution is benign. Diagnosis of bathing epilepsy requires the exclusion of other paroxysmal disorders triggered by water contact. Video‐EEG confirmation of the seizures is necessary to reach a diagnosis of certainty and to allow adequate management. We present the case of a one‐year‐old boy who experienced recurrent episodes of unresponsiveness and cyanosis while bathing in lukewarm water. The diagnosis of bathing epilepsy was confirmed by the video‐EEG recording of a seizure, showing left‐sided frontotemporal delta activity with rapid contralateral spread. Therapy with levetiracetam was effective, subsequently allowing bathing without further seizures.

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“…A genetically aberrant thermoregulatory system or an anatomical abnormality of the temporo-insular and parietal networks has been suggested as a possible mechanism for epiloptogenesis. 19,20 HWE is caused by an X-linked gene-such as SYN1 -in a significant proportion of individuals. 21 Conclusions: Intermittent clobazam prophylaxis prior to hot water bath, as well as changing bathing habits can be effective in pediatric patients with hot water epilepsy.…”

Section: Highlightmentioning

confidence: 99%

Clinical and EEG features, treatment, and outcome of hot water epilepsy in pediatric patients

et al. 2020

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Background: Hot water epilepsy is a type of reflex epilepsy which generally occurs with pouring water on the body during bath. Objective: The aim of this study is to evaluate the clinical and electrophysiological features, treatment, and outcome of the pediatric patients with diagnosis of hot water epilepsy. Methods: Patients were followed and treated at Erciyes University, between January 2010 and January 2016. Results: There were 15 patients total, included 9 (60%) boys and 6 (40%) girls. The average age at diagnosis was 30 months (range: 13-60 months). The follow-up period was 16 months (range: 12-48 months). Seven patients (46.6%) had focal seizures with impaired consciousness, four (26.7%) had focal seizure and four (26.7%) had focal starting and generalized tonic-clonic continuing seizures. Seven patients (46.6%) had abnormal interictal EEG findings, ranged from unilateral slowing of the background activity to bilateral sharp wave. Intermittent clobazam treatment (0.8-1.2 mg/kg) was given to 13 patients (86.7%). Other epileptic treatments were used in 5 (33.3%) patients. Three patients (20.0%) developed nonreflex seizures during followup period. Conclusions: Intermittent clobazam prophylaxis prior to hot water bath, as well as changing bathing habits can be effective in pediatric patients with hot water epilepsy.

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Ictal Video-Electroencephalography Findings in Bathing Seizures: Two New Cases and Review of the Literature

Cited by 10 publications

References 19 publications

Clinical and Genetic Features in Patients With Reflex Bathing Epilepsy

Clinical and Genetic Features in Patients With Reflex Bathing Epilepsy

Bathing epilepsy: a video case report

Clinical and EEG features, treatment, and outcome of hot water epilepsy in pediatric patients

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