ABSTRACT

Hot water epilepsy is a kind of reflex epilepsy in which seizures are initiated by exposure of the head and/or body to hot water. Presently described are 5 cases from an epilepsy outpatient clinic that were diagnosed between 2012 and 2018. None of the patients had a history of cranial trauma, febrile convulsion, or a family history of epilepsy/hot water epilepsy. Two of patients were men and the remaining 3 were women. Both of the male patients described an aura of pleasure during the seizure; only 1 had a history of self-induction. Interictal electroencephalographies were normal in 4 cases and demonstrated mild hemispheric asymmetry in the fifth patient. All of the patients had a normal cranial magnetic resonance imaging result. One patient experienced non-reflex seizures during sleep. A noteworthy fact was that non-reflex seizures always occurred while she was dreaming of bathing. She had a suicide attempt in 2017. In 3 patients, seizure control was achieved via antiepileptic medications, while changing the bathing habits was sufficient in 2 cases. These cases of hot water epilepsy represent 2 types of seizures (focal seizures with impaired awareness and unknown onset impaired awareness seizures). One of the patients experienced recurrent seizures because of a drug import problem.

Keywords: Reflex epilepsy, hot water epilepsy, treatment of hot water epilepsy