Abstract
Hot water epilepsy (HWE) is a subtype of reflex epilepsy in which seizures are triggered
by the head being immersed in hot water. Hot water or bathing epilepsy is the type
of reflex epilepsy most frequently encountered in our clinic. We describe our patients
with HWE and also discuss the clinical features, therapeutic approaches, and prognosis.
Eleven patients (10 boys, 1 girl), aged 12 months to 13 years, admitted to the pediatric
neurology clinic between January 2018 and August 2019, and diagnosed with HWE or bathing
epilepsy based on International League Against Epilepsy (ILAE)-2017, were followed
up prospectively for ∼18 months. Patients' clinical and electroencephalography (EEG)
findings and treatment details were noted. All 11 patients' seizures were triggered
by hot water. Age at first seizure was between 2 months and 12 years. Seizure types
were generalized motor seizures, absence, and atonic. EEG was normal in two patients,
but nine patients had epileptiform discharges. Magnetic resonance imaging of the brain
was performed and reported as normal (except in one case). Histories of prematurity
were present in two patients, unprovoked seizures in one, and low birth weight and
depressed birth in the other. Patients with HWE have normal neuromuscular development
and neurological examination results, together with prophylaxis or seizure control
with a single antiepileptic drug, suggesting that it is a self-limited reflex epilepsy.
Keywords
bathing - hot water epilepsy - treatment - prognosis
