Appavu Brian, Fox Jordana, Little Robert, Kerrigan John F, Obeid Makram
*Department of Neurology, Division of Epilepsy, Neurological Institute of New York, Columbia University Medical Center, New York, NY Departments of †Neurology ‡Neurology, Division of EpilepsyBarrow Neurological Institute at Phoenix Children's Hospital, Phoenix §Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, Comprehensive Epilepsy Center ∥Department of Anatomy, Cell Biology, and Physiological Sciences, American University of Beirut Medical Center, Lebanon.
Neurologist. 2017 Sep;22(5):196-198. doi: 10.1097/NRL.0000000000000138.
Reflex epilepsies represent a form of epilepsy in which unique modes of seizure precipitation are characterized by endogenous or exogenous stimuli. Hot water epilepsy represents a subtype of reflex epilepsy in which seizure precipitation arises from the act of immersing the head with hot water. Bathing epilepsy represents another subtype of reflex epilepsy in which seizure precipitation arises from the immersion with water at lukewarm temperatures.
We report on 2 boys with a unique form of bathing epilepsy characterized by the act of exiting out of water. The first patient had a family history significant for a brother with frontal lobe epilepsy. He underwent an evaluation in the epilepsy monitoring unit in which a reflex seizure was recorded while exiting the shower. This seizure was characterized by an ictal onset in the left frontal lobe and subsequent secondary generalization. The second patient initially had nonreflex seizures arising from the left temporal lobe and went on to develop reflex seizures upon exiting water. For both patients, the precipitation of seizures was independent of water or environmental temperature, exposure of specific body parts, or duration of water immersion. Both children experienced a sensation of coldness, followed by convulsive or atonic activity.
Our cases represent a unique form of bathing epilepsy in which seizure precipitation is dependent upon exiting water.
反射性癫痫是癫痫的一种形式，其独特的发作诱发模式以内源性或外源性刺激为特征。热水癫痫是反射性癫痫的一种亚型，其发作由头部浸入热水的行为诱发。沐浴癫痫是反射性癫痫的另一种亚型，其发作由浸入温水诱发。
我们报告了2例具有独特形式的沐浴癫痫的男孩，其发作由出水行为诱发。首例患者有家族病史，其兄弟患有额叶癫痫。他在癫痫监测单元接受评估，期间在淋浴出水时记录到一次反射性发作。此次发作的特点是发作起始于左侧额叶，随后继发全面性发作。第二例患者最初有起源于左侧颞叶的非反射性发作，后来在出水时出现反射性发作。对于这两名患者，发作的诱发与水温或环境温度、特定身体部位的暴露或浸水时间无关。两名儿童均先有寒冷感，随后出现惊厥或失张力活动。
我们的病例代表了一种独特形式的沐浴癫痫，其发作诱发取决于出水。
