Clinical, Demographic, and Electroencephalographic Profile of Hot-Water Epilepsy in Children

Area of Science:

• Pediatric Neurology
• Epileptology
• Clinical Neuroscience

Background:

• Hot-water epilepsy (HWE) is a reflex epilepsy triggered by hot water immersion.
• Understanding HWE's clinical and diagnostic features is crucial for timely intervention in pediatric populations.

Purpose of the Study:

• To characterize the clinical, demographic, risk factor, electroencephalographical, and neuroimaging features of hot-water epilepsy in children.
• To identify key indicators for diagnosing and managing HWE in pediatric patients.

Main Methods:

• A hospital-based observational study conducted in a pediatric neurology clinic.
• Data collected included clinical history, demographics, examination findings, electroencephalography (EEG), and neuroimaging.
• Study period: January 2017 to October 2018, involving 68 children meeting HWE criteria.

Main Results:

• The male to female ratio was 2.4:1, with the most common age of seizure onset between 1 and 5 years.
• Focal seizures with impaired awareness were the most frequent semiology (48.5%).
• Abnormal EEG (13.2%) and neuroimaging (4.4%) were infrequent, often incidental. Non-reflex seizures occurred in 35.3% without significant risk factors. Clobazam achieved seizure control in 85.7%.

Conclusions:

• Hot-water epilepsy should be suspected in children experiencing seizures after hot water baths.
• The typical age of onset is 1-5 years, with normal EEG and neuroimaging in most cases.
• Non-reflex seizures are observed in a significant proportion (35.3%) of children with HWE.