Epileptic Disorders
MENUEpileptic seizures provoked by bathing with water at room temperature Volume 14, issue 3, September 2012
A partial seizure with generalisation was provoked in the infant by immersion with lukewarm water during bathing. The seizure onset was characterised by staring, confusion, non-forced right head deviation, and immobility. EEG showed a paroxysmal slowing of the basic rhythm followed by 2-3 Hz high-voltage delta waves, starting above the right fronto-temporal region. The fast unilateral spreading of slow activity and sharp waves was registered with increasing amplitude and decreasing frequency over the whole right hemisphere. After 42 seconds from the seizure onset, the EEG showed diffuse dissemination of high-amplitude (200-300 mcV) rhythm at 2-3 Hz, with clinical correlation of seizure generalisation. After 68 seconds from seizure onset, diazepam was given rectally and the seizure stopped after one minute. During the last 20 seconds of the course of the seizure, oral and hand automatisms were observed while EEG showed rhythmic repetitive sharp waves over the left temporal-parietal region. A) 08.21.24: seizure onset; B) 08.22.05: generalisation; C) 08.22.32: diazepam application; D) 08.23.30: the end of the seizure. EEG conditions: longitudinal montage, calibration: 70 mcV; speed: 10 s/page.
> DownloadAn epileptic attack of complex partial seizure type, provoked by pouring lukewarm water over the child's body, was recorded by video-EEG monitoring. The attack started at 18:36:31 and finished at 18:38:29, according to the time displayed on the video-EEG. The seizure started as motor arrest and staring, with EEG correlate of rhythmic slow waves at 3-4 Hz over the left hemisphere, which continued for the next 42 seconds. From 18.36.50, biphasic sharp waves were registered above the anterior temporal left region for seven seconds. From 18:37:13 to 18:38:29, the child was motionless, stared, had oral automatisms and perioral cyanosis, and showed occasional generalised atonia with head drop. During this period, the EEG showed generalised delta activity with progressive slowing and increase of amplitude starting approximately one second earlier over the left fronto-central region. Towards the end of the attack, from 18:37:44 to 18:37:59, the short periods of EEG attenuation were recorded interchanging with periods of generalised delta activity. After spontaneous seizure cessation, the child started to cry and regained motor activity. Background activity became normal, consisting dominantly of fast symmetric theta waves. EEG conditions: longitudinal montage, calibration: 70 mcV; speed: 10 s/page.