Hot water epilepsy clinical profile and treatment--a prospective study.
OBJECTIVE
This study characterized the demographic, clinical, EEG and imaging profile, and therapeutic outcome among patients with hot water epilepsy (HWE).


METHODS
This prospective study included 70 patients with HWE (M:F=55:15; age: 25.3±8.4 years). Details of demography, seizure characteristics and outcome, and imaging/EEG observations were recorded.


RESULTS
There was male dominance. Majority of the patients belonged to Mandya: 30.5%, Ramanagara: 30.0% and Mysore: 15.2% districts of Karnataka, India. Forty-five patients (M:F=37:8; age: 24.6±10.1 years) had features of 'HWE alone'. Twenty-five (M:F=18:7; age: 26.7±7.9 years) had HWE with spontaneous seizures. The age at onset of seizures was comparable in both the groups - HWE: 18.7±10.2 years vs. HWE with spontaneous seizure: 16.8±10.3 years (p=0.34). The duration of seizures were more in HWE with spontaneous seizure group: 119.5±66.9 months compared to HWE alone: 69.9±13.8 months (p=0.028). Inter-ictal EEG (n=70) showed epileptiform activities in 15 patients (21.4%). The therapeutic outcome after 3-8 months of follow up were - (a) HWE group: 6 stopped hot water head bath; 39 were on intermittent clobazam therapy - seizure free: 33; and 6 received AEDs; (b) HWE with spontaneous seizure group: all were on AEDs and seizure free.


CONCLUSIONS
Three-fourth of patients belonged to 'Mandya-Mysore belt of Karnataka'. There was increased duration of seizures among those with additional spontaneous seizure. About 3/4th subjects with HWE alone were seizure free with intermittent clobazam and remaining patients on AEDs were seizure free, confirming the earlier observations from this center.
Department of Neurophysiology, National Institute of Mental Health and Neuroscience, Bangalore, India.
A
A
Meghana
S
S
Sinha
T N
TN
Sathyaprabha
D K
DK
Subbakrishna
P
P
Satishchandra
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014867:Water / Q000009:adverse effects; D055815:Young Adult
D000927:Anticonvulsants; D014867:Water