title: Focal epilepsy presenting as a bath-induced paroxysmal event/breath-holding attack.
abstract: Bath-induced paroxysmal events in infants and children can be triggered by various etiologies, including cardiological, neurological, and metabolic causes. It is important to ascertain the underlying cause for such events as this significantly affects the child's management and prognosis. We present the case of a 19-month-old boy who presented with recurrent episodes of apnea, cyanosis, and reduced level of consciousness in response to bathing. Through detailed history and investigation, the diagnosis of water reflex epilepsy was made. Treatment with carbamazepine and adjustment of the bathing technique have prevented further episodes from occurring, and the child's growth and development are progressing normally.
  
  
  CONCLUSIONS
  Water reflex epilepsy can mimic a range of other conditions, and a high index of suspicion is required to establish the diagnosis. Children with water reflex epilepsy can achieve a good quality of life with modified bathing and appropriate antiepileptic medication.
authors: Royal United Hospital Bath, Combe Park, Bath BA1 3NG, UK.
authors: C J
authors: CJ
authors: Stutchfield
authors: Royal United Hospital Bath, Combe Park, Bath BA1 3NG, UK.
authors: N R
authors: NR
authors: Loh
keywords: Bath-induced; ECG, electrocardiogram; ED, emergency department; EEG, electroencephalogram; MRI, magnetic resonance imaging; PEPD, paroxysmal extreme pain disorder; Paroxysmal events; Water reflex epilepsy