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

Abstract

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.