Reflex epilepsy from hot water: A new case and review of the literature

Introduction. In approximately 5% of epilepsy patients, seizures are triggered off by a specific sensory stimulus, in other words, they have reflex epilepsies. Among these, seizures triggered off by by hot water are exceptional, and especially so in our community as nearly all the cases have been reported as occurring in India. Case report. Our case involves a 2 year old girl who, from the first weeks onwards, presented bouts of paleness, hypotonia and loss of consciousness when her head came into contact with hot water. The findings from clinical, neurophysiological and neuroimaging studies are described and there was a good response to treatment with valproate. Discussion. The induction of epileptic seizures by immersion in hot water has only rarely been reported in western countries. Its physiopathology remains unknown but genetic factors that determine an alteration in cranial thermoregulation seem to be involved. With similar clinical and electroencephalographic characteristics inpatients, the prognosis is usually favourable because of a good response to pharmacological treatment and the tendency toward spontaneous remission of the seizures.