Reflex-epilepsy induced by tap water bath: a case report and literature review

ABSTRACT

Reflex epilepsy is a condition in which seizures can be provoked habitually by exclusively external stimulus or, less commonly, internal mental processes. It may coexist with spontaneously occurring seizures. Reflex seizures are epileptic rather than psychogenic in nature, presenting often as either focal-onset or primary generalized seizures, with epileptiform EEG changes. Bathing epilepsy or as commonly named hot water epilepsy [HWE], is a form of reflex or sensory epilepsy in which seizures are precipitated by the contact of hot or tepid water over the head and body. We report a case of an 18-month-old Sudanese toddler boy, presented with recurrent abnormal funny turns, noticed by his parents, since he was 6-month old. These events occur while having a bath by pouring tap water over his head. The diagnosis of epilepsy was supported by interictal electroencephalography [EEG]. This rare type of epilepsy has a geographical distribution. Reflex epilepsies have different precipitation factors. The identification of these factors is important in the management and outcome. Hot water epilepsy had been reported in certain geographic areas and ethnicities. To our knowledge, this is the first case to be reported from African and Arab Nations.