title: Intermittent clobazam prophylaxis in hot water epilepsy is safe and effective: a prospective study.
abstract: OBJECTIVE
  To evaluate the role of intermittent prophylaxis with clobazam in the management of HWE in a long-term prospective study.
  
  
  METHODS
  Two hundred and sixty patients [M:F - 194:66] with HWE were recruited. Patients were divided into: (a) 'HWE alone' (n=198) - received intermittent clobazam prophylaxis, 1-1½h prior to hot water head bath (group A); (b) 62 patients (20.4%) with 'HWE with spontaneous seizures were treated with continuous AEDs along with intermittent clobazam therapy (group B).
  
  
  RESULTS
  Patients (n=198) in group A was followed for mean of 17.6 ± 10.6 months (range: 3-57). One hundred and forty seven patients (74.2%) had excellent response with complete seizure freedom with clobazam therapy while 12 (6.1%) had >75% reduction in seizure frequency. Remaining 39 (19.7%) required additional standard AED along with clobazam and 18 patients among them developed spontaneous/unprovoked seizure at follow up of 6.7 ± 4.1 months. Forty five patients in group B were seizure free while on continuous AEDs.
  
  
  CONCLUSIONS
  Intermittent clobazam prophylaxis prior to head water bath might be a preferred mode of treatment of pure HWE. Additional AEDs are required if they have associated non-reflex unprovoked seizure.
authors.affiliation: Department of Neurology, National Institute of Mental Health and NeuroSciences [NIMHANS], Bangalore, India. Electronic address: drpsatishchandra@yahoo.com.
authors.forename: P
authors.initials: P
authors.lastname: Satishchandra
authors.affiliation: Department of Neurology, National Institute of Mental Health and NeuroSciences [NIMHANS], Bangalore, India. Electronic address: drdilips@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Dilipkumar
authors.affiliation: Department of Biostatistics, National Institute of Mental Health and NeuroSciences [NIMHANS], Bangalore, India. Electronic address: drsubbakrishna50@yahoo.com.
authors.forename: D K
authors.initials: DK
authors.lastname: Subbakrishna
authors.affiliation: Department of Neurology, National Institute of Mental Health and NeuroSciences [NIMHANS], Bangalore, India. Electronic address: sanjib_sinha2004@yahoo.co.in.
authors.forename: S
authors.initials: S
authors.lastname: Sinha
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000078306:Clobazam; D004569:Electroencephalography; D004827:Epilepsy / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D008297:Male; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D001569:Benzodiazepines; D000078306:Clobazam
keywords: AEDs; Clobazam prophylaxis; Hot water epilepsy; Non-reflex seizure