2020 Volume 69 Issue 3 Pages 481-487
The patient was an 11-month-old boy who had no epileptic history. He showed poor lip color and sursumvergence after hot bathing as the first seizure attack. Three days later, he showed repetitive seizure attacks and he was brought to our hospital. We observed right temporal onset focal seizure in electroencephalography (EEG) recording. Therefore, he was administered carbamazepine. Two months later, he had seizure attacks again for three days after bathing, and carbamazepine was switched to phenobarbital. We suspected that bathing precipitated seizure, and thus he was given a shower instead of a hot bath. Although he was taking a shower, the number of seizures was not reduced. We tried to perform video-EEG recording during his bathing in an EEG room to capture a seizure attack and we successfully recorded his seizure after taking a bath. The EEG showed right temporal rhythmic slow waves in the ictal period and generalized slow waves, which later finally attenuated. This epileptic seizure was defined as right temporal onset focal seizure with dyscognitive and autonomic symptoms. We considered that it was a type of reflex epilepsy, and the precipitant was wiping up following hot bathing. It seemed difficult to perform EEG recording during bathing; however, we were able to record the time of his specific seizure by replicating the circumstances that could induce the usual attacks. It is important to capture seizures by video-EEG recording especially in children to contribute to correct diagnosis and treatment.
