Focal epilepsy presenting as a bath-induced paroxysmal event/breath-holding attack

Area of Science:

• Pediatric Neurology
• Epileptology

Background:

• Paroxysmal events in infants and children require thorough etiological investigation.
• Cardiological, neurological, and metabolic causes are common triggers for such events.
• Accurate diagnosis is crucial for effective management and prognosis.

Observation:

• A 19-month-old boy experienced recurrent apnea, cyanosis, and decreased consciousness triggered by bathing.
• These episodes mimicked other serious conditions, necessitating a comprehensive diagnostic approach.

Findings:

• The patient was diagnosed with water reflex epilepsy, a rare form of reflex epilepsy.
• Carbamazepine treatment and adjusted bathing techniques effectively controlled the seizures.
• The child's development and growth normalized post-intervention.

Implications:

• Water reflex epilepsy diagnosis requires a high index of suspicion due to its varied presentation.
• Effective management involves antiepileptic medication and environmental modifications, such as altered bathing practices.
• Children with this condition can achieve a good quality of life with appropriate care.