Reflex-Epilepsy Induced by Immersion in Hot Water

Roos, R.A.C.; Dijk, J.G. van

doi:10.1159/000116219

Cited by 24 publications

(18 citation statements)

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“…Antiepileptic drug therapy is only indicated when those measures fail or when other types of epilepsy are involved. Since seizure s f requently show a tendency to decrease spontan e o-usly, withdrawal of medication should be carefully undertaken only after several years 13,14 .…”

Section: Discussionmentioning

confidence: 99%

"Hot-water epilepsy ", "warm-water epilepsy", or bathing epilepsy? Report of three cases and considerations regarding an old theme

Kowacs

Marchioro²,

Silva

et al. 2005

Arq. Neuro-Psiquiatr.

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.ABSTRACT -Partial and generalized tonic-clonic reflex seizures related to hot water bathing have been described as temperature-related. We describe three cases of bathing epilepsy: a 28 year-old white male and a 30 year-old white female with spells triggered either by warm or hot water, and a 32 year-old female with spells triggered by hot water. The later two of the three cases presented localized epilepsy and a familial history of epilepsy. A complex tactile stimuli might play the most relevant role on seizure triggering, as well as water temperature with an additive effect over cutaneous stimulation.KEY WORDS: epilepsy, epilepsy-generalized, epilepsy-localized, seizures-reflex, hot-water epilepsy.Epilepsia do banho quente, do banho morno, ou apenas do banho? Relato de três casos e considerações sobre um velho tema RESUMO -Crises reflexas a banhos quentes, tônicas-clônicas parciais e generalizadas foram descritas como relacionadas à temperatura. Descrevemos três casos de epilepsia do banho quente: um homem de 28 anos e uma mulher de 30 anos com crises provocadas por contato com água morna ou quente e uma mulher de 32 anos com crises ao contato com água quente. Os últimos dois casos apresentaram epilepsia localizada e um histórico familiar de epilepsia. Nesta forma de epilepsia, um estímulo táctil complexo parece ter o p a p e l mais relevante na precipitação das crises, sendo potencializado pela temperatura da água. PALAVRAS-CHAVE: epilepsia, epilepsia generalizada, epilepsia localizada, crises reflexas, epilepsia do banho quente.Hot water epilepsy has been previously studied and re p o rted, occurring mainly in India 1 , 2 , 3 . Both partial and generalized tonic-clonic seizures related to hot water bathing have been described as tempera t u re -related, often triggered by temperatures ranging from 40 to 50 o C 1 -3 . As in many other types of re f l e x s e i z u res, the same stimulus (hot water) triggers either generalized tonic-clonic or partial seizures, suggesting that generalized and localized epilepsies might be influenced by the same aff e rent pathways.We describe three cases of bathing epilepsy, one t r i g g e red by hot water, and the other two either by w a rm or hot water. The pathophysiological significance of seizure triggering by warm water and the proper denomination of this syndrome is discussed. CASESCase 1 -A 28 year-old white male started having seiz u res at the age of 7. Seizures would start with dizziness, followed by left hemiclonic seizures starting on his left arm . He had had birth anoxia, and his brother also had epileps y. Seizures were initially controlled with phenobarbital, but re c u rred at the age of 14, when partial seizures characterized by bilateral headache, cephalic paresthesia, and a negative motor phenomenon on his left upper limb w e re triggered either by warm (but not cold) or hot water. Symptoms lasted about 5 minutes. The CT was normal, but an interictal EEG showed a right rolandic focus and an independent left temporal spiking. Carbamazepine 1200mg/day...

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Section: Discussionmentioning

confidence: 99%

"Hot-water epilepsy ", "warm-water epilepsy", or bathing epilepsy? Report of three cases and considerations regarding an old theme

Kowacs

Marchioro²,

Silva

et al. 2005

Arq. Neuro-Psiquiatr.

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show abstract

“…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].…”

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“…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].…”

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confidence: 99%

“…Of the seizures, 67%-71% are of the complex partial type, with or without secondary generalisation [1,3,4,5]. About 33% are primarily generalised, usually tonicclonic [5].…”

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“…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]. Seizures last from 30 s to 3 min and can manifest at any time during bathing [5,6].…”

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