NEW YORK, Feb 22 (Reuters Health) -- Bathing is a routine part of infant
care. But in rare cases, hot water can cause a mild epileptic seizure in young
children, researchers report.
"Hot water epilepsy" can be treated with simply lowering the temperature
of water used to wash the infant, although some cases require an antiepileptic
drug.
Previous cases of this so-called "hot water epilepsy" have been reported
by Asian researchers. A new study led by Dr. Christie Ioos of the Raymond
Poincaré Hospital in France, documents five cases among children in Europe.
These cases involved children between the ages of 6 months and 2 years who were
admitted to French hospitals after experiencing seizures in the bath.
In one case, a six-month-old boy started jerking violently after being
placed in the tub. He then became unresponsive, staring blankly into space.
Several similar episodes followed.
The boy's parents brought him to the hospital, where doctors tried to
recreate the conditions leading to his attacks. They placed him in a bath of hot
water, and monitored his vital signs. After 30 seconds in the bath, the baby had
a seizure.
In another case, a 7-month-old girl repeatedly became floppy and listless
after being placed in the bath. Her lips would turn blue, and her eyes would
roll up in her head. After realizing her seizures were triggered by hot water,
doctors were able to prevent them through the use of anti-epileptic drugs.
In all cases, the seizures were non-fatal, and the children were
effectively treated through anti-epilepsy medication or by changes in their
bathing routines, the researchers note in their paper, published in the Journal
of Child Neurology.
They also note that the children were generally healthy, and developed
normally.
The recently reported European cases only represent five incidents over
the course of four years (1992-1996). But hot water epilepsy is relatively more
common in Asia. This is particularly true in southern India, where researchers
documented almost 280 cases between 1980 and 1983.
Unlike the European victims, who averaged in age between six months and
two years, Indian children with hot water epilepsy tend to be older, with an
average age of thirteen. Also, Indian sufferers tended to use hotter bathing
water than Europeans, with temperatures ranging between 40 and 50 degrees
Celsius.
Given the relatively high rate of hot water epilepsy among southern
Indians, this regional variation may have genetic roots, the researchers
suggest. Indeed between 7% and 18% of south Indians suffering from hot water
seizures have a family history of the attacks. Besides India, Turkey and Japan
have the highest rates of the disease.
Scientists are not sure what causes the disorder, but they believe that
patients susceptible to hot water epilepsy have trouble regulating their body
temperatures. As a result, they are sensitive to rapid rises in temperature.
Research suggests that both the tactile sensation of water as well as its
temperature may trigger the seizures.
While rare, hot water seizures may be more common than reported, the
researchers suggest. Sometimes parents give children baths as a treatment for
fevers. But fevers can also produce convulsions, with the result that hot water
seizures resulting from the bathing of feverish kids could sometimes be
misinterpreted as a fever-induced fit. Observing a child having a fit in the
bath is not enough, diagnosis of hot water epilepsy requires simultaneous
recording of brain waves (EEG) and heart rhythm (ECG), the researchers conclude.
