One tablet can ensure them safe hot water bath

This is a rare form of epilepsy occurring mostly in the states of Karnataka and Tamil Nadu. It is characterised by seizures while taking a hot water head bath, and is found more commonly among children.

Hot water epilepsy (HWE) constitutes four per cent of total epilepsy cases. “The frequency of the attacks may vary from once to thrice in a month. If not treated, the frequency will increase, and in some cases may lead to kindling of the brain,” says Dr P Satishchandra from Nimhans, who has been involved in HWE research for almost two decades now.

HWE is caused due to thermo-regulatory abnormality, meaning that when the temperature of the water used for bathing goes above a particular temperature, it induces fever in a span of just a couple of minutes. The rapidity of the increase in body temperature results in seizures attack. Another peculiar phenomenon found in HWE patients is the pleasure sensation they experience when they bathe in hot water. “As the patient begins to pour hot water over his head, he experiences pleasure sensations, which urge him to keep bathing in hot water,” explains Dr Satish.

The disorder is also said to have a genetic basis with 7-20 per cent of the patients having a family history. HWE has genetic susceptibility with environmental interaction. “There is a genetic linkage observed with the 4th and 10th chromosome. There are families where 8 or 11 members are suffering from HWE,” Dr Satish adds.

Until a few years ago, the solution seemed to be to bathe in lukewarm water, but now a permanent solution has been found in the tablet Clobazam. One tablet taken 90 minutes before bath provides patients with 100 per cent relief from any kind of seizure.
Associated problems

Dr Dhananjaya who specialises in co-morbid psychiatric illnesses at ESI Model Hospital says that it is common for a hot water epileptic patient to go through depression. “Depression can indirectly lead to increase in the frequency of seizures due to non-compliance with doctors’ advice among patients,” he points.

Doctors advice immediate consultation with a physician at the onset of even one such seizure. “HWE patients can lead completely normal lives. They generally have normal physical and mental development,” says Dr Dhananjaya, who on an average gets five to six cases of HWE per month.

The good news about HWE is that it can eliminated completely with correct medication and treatment.