Turgay Cokyaman, Gurkan Gurbuz, Guldemet Kaya

Hot water epilepsy under 3 years of age: A short term follow-up study

Aim: Hot water epilepsy (HWE) is a type of reflex epilepsy that occurs as a result of immersing or pouring hot water over the head. Clinical and laboratory findings and short-term neurodevelopmental outcomes of patients were discussed in this report. Materials and Methods: Eight patients under the age of three and followed-up with a diagnosis of HWE between 2017 and 2020 were enrolled in the study. Patient files were evaluated retrospectively. Results: All our patients except one were boys. The patients’ mean age at admission was 16.6 months (min: 10, max: 36), and the mean follow-up period was 13.5 months (min: 6, max: 25). Two patients also experienced non-reflex motor seizures not related to bathing, and these received daily oral antiepileptic therapy. Six patients had focal onset secondary generalized seizures, while one had focal seizures and one has hypomotor seizures accompanied by loss of consciousness. neurodevelopmental milestones were compatible with the patient’s age in all followed-up cases. Clobazam administration before bathing is currently an effective and easily applicable method for this condition. Conclusion: Hot water epilepsy is mostly benign. Clobazam before bathing is an effective option. Daily oral antiepileptic therapy should be administered to patients with seizures accompanying HWE.

PDF

___

1. Allen IM. Observations on cases of reflex epilepsy. N Z Med J 1945;44:135-42.
2. Kurata S. Epilepsy precipitated by bathing: A followup study. BrainDev 1979;11:400-5.
3. Satishchandra P, Shivaramakrishna A, Kaliaperumal VG, Schoenberg BS Hot water epilepsy: a variant of reflexepilepsy in Southern India. Epilepsia 1988;29:52- 6
4. Bebek N, Gurses C, Gokyigit A et al. Hot water epilepsy: clinical and electrophysiologic findings based on 21 cases. Epilepsia 2001;42:1180-4.
5. Fischer RS, Robert S, French, JA. et al. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017;58:522-30.
6. Klauenberg BJ, Sparber SB. A kindling-like effect induced by repeated exposure to heated water in rats. Epilepsia. 1984;25:292-301.
7. Kowacs PA, Marchioro IJ, Silva EB Jr et al. "Hot-water epilepsy ", "warm-water epilepsy", or bathing epilepsy? Report of three cases and considerations regarding an old theme. Arq Neuropsiquiatr 2005;63:399-401.
8. Karan KR, Satishchandra P, Sinha S, Anand A. Rare SLC1A1 variants in hot water epilepsy. Hum Genet 2017;136:693-703.
9. Satishchandra P. Hot-water epilepsy. Epilepsia 2003;44:29-32.
10. Grosso S, Farnetani MA, Francione S, et al. Hot water epilepsy and focal malformation of the parietal cortex development. Brain Dev 2004;26:490-3.
11. Patel M, Satishchandra P, Aravinda H et al. Hot water epilepsy: Phenotype and single photon emission computed tomography observations. Ann Indian Acad Neurol 2014;17:470-2.
12. Kaplan Y, Kurt SG, Karaer H et al. Intra-familial incidence and characteristics of hot water epilepsy. Can J Neurol Sci 2009;36:575-81.
13. Erdem E, Topcu M, Renda Y, et al. Hot water epilepsy. Clin Electroencephalogr 1992;23:152-8.
14. Zeki G, Ilker IH, Hidir UU, Zeki O. Hot water epilepsy: seizure type, water temperature, EEG findings and treatment published correction appears in Neurologist 2010;16:210.
15. Sirsi D, Armstrong D, Munoz-Bibiloni J et al. SYN1 Gene Mutation in a Child with Focal Epilepsy and Reflex Bathing Seizures J Pediatr Epilepsy 2017;6:119-24.
16. Incecik F, Herguner MO, Elkay M, Altunbasak S. Hot water epilepsy - a report of three cases. Indian Pediatr 2004;41:731-3.
17. Dhanaraj M, Jayavelu A. Prophylactic use of clobazam in hot water epilepsy. J Assoc Physicians India 2003;51:43-4.
18. Savitha MR, Krishnamurthy B, Ashok DA, Ramachandra NB. Self abortion of attacks in patients with Hot Water Epilepsy. Indian Pediatr 2007;44:295-8.