EEG source estimation in a rare patient with cold-induced reflex epilepsy

Temperature-related reflex epilepsy most often takes the form of hot water epilepsy, but very rarely, reflex epilepsy is related to cold temperature. We report a 70-year-old male who had seizures triggered by cold sensations in the body. Four antiepileptic drugs were taken during the drug treatment, and oxcarbazepine was the most effective at stopping the seizures. We implemented clinical seizure induction and obtained EEG data from an interictal period and two complete ictal periods. Source estimation was performed to identify and map the primary sources involved in the seizures on the cortical level. We found that β rhythm appeared on the prefrontal lobes during the whole ictal period. The low-frequency slow δ and θ rhythms, especially the δ rhythm, appeared in the occipital lobe in the early ictal stage and propagated to the right temporal lobe in the mid-late ictal stage. The prefrontal lobe and right temporal lobe were mainly involved in the generation and propagation of the epileptic activities. This study provides a valuable reference for clinical drug therapy and provides insights into the characteristics of the brain activities involved in cold-induced reflex epilepsy. [Published with video sequences].