Epilepsy Research (2012) 102, 160—166 j ourna l ho me pag e: www.elsevier.com/locate/epilepsyres Hot water epilepsy clinical profile and treatment—–A prospective study A. Meghana a , S. Sinha b,* , T.N. Sathyaprabha a , D.K. Subbakrishna c , P. Satishchandra b a Department of Neurophysiology, National Institute of Mental Health and Neuroscience (NIMHANS), Bangalore, India b Department of Neurology, National Institute of Mental Health and Neuroscience (NIMHANS), Bangalore, India c Department of Biostatistics, National Institute of Mental Health and Neuroscience (NIMHANS), Bangalore, India Received 4 February 2012; received in revised form 21 May 2012; accepted 28 May 2012 Available online 22 June 2012 KEYWORDS Clobazam; Hot water epilepsy; Treatment of HWE Summary Purpose: This study characterized the demographic, clinical, EEG and imaging profile, and therapeutic outcome among patients with hot water epilepsy (HWE). Methodology 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. Result: 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 com- parable 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. © 2012 Elsevier B.V. All rights reserved. ∗ Corresponding author at: NIMHANS, Bangalore 560 029, Kar- nataka, India. Tel.: +91 80 26995150; fax: +91 80 26564830. E-mail address: sanjib sinha2004@yahoo.co.in (S. Sinha). Introduction Seizures precipitated by a specific sensory stimulus are described as reflex epilepsy. Reflex epilepsies are interesting not only because of their being intriguing neurobehavioral 0920-1211/$ — see front matter © 2012 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.eplepsyres.2012.05.011