A Young man with Peri-ictal water drinking

Neuro-vegetative features have been linked to epilepsy arising from the temporal lobe, which can be seen during ictal events and play an important role in determining the focal side of the lesion. Among the rare known features is peri-ictal water drinking (PIWD). Here, we present the case of a 31-year-old male with refractory temporal epilepsy, having episodes of PIWD. The patient was considered a candidate for resective surgery and was investigated accordingly, including long-term video electroencephalogram (EEG), brain magnetic resonance imaging (MRI), and neuropsychology assessment, which pointed towards a lesioned temporal lobe over the non-dominant hemisphere. The patient had an excellent outcome following right anterior temporal lobectomy. The lateralization significance of PIWD has not yet been established definitively in the literature, partly due to a limited number of published cases. This case highlights the previously observed association between PIWD and the involvement of the non-dominant hemisphere in epilepsy patients.