John Libbey Eurotext

Peri-ictal water drinking: a rare automatic behaviour in temporal lobe epilepsy Volume 17, issue 4, December 2015


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1 Division of Neurology, Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Rome
2 Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari
3 Division of Neurology, Campus Biomedico University, Rome
4 Clinical Psycology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Rome
5 Division of Neurology, SS. Annunziata Hospital, Taranto, Italy
* Correspondence: Nicola Specchio Division of Neurology, Bambino Gesù Children's Hospital, IRCCS, P.zza S. Onofrio 4 00165, Rome, Italy

Peri-ictal water drinking (PIWD) has been reported as the action of drinking during or within two minutes of an electroclinical seizure. It is considered a peri-ictal vegetative symptom, evident both during childhood and adulthood epilepsy. The aim of this paper was to describe the clinical and electroencephalographic features of two new adult subjects suffering from symptomatic temporal lobe epilepsy with episodes of PIWD recorded by VIDEO-EEG and to review literature data in order to better define this peculiar event during seizures, a rare and probably underestimated semiological sign. To date, 51 cases with focal epilepsy and seizures associated with PIWD have been reported. All patients presented with temporal lobe epilepsy. All cases but one had symptomatic epilepsy. Most of the patients had an involvement of the right hemisphere. Water drinking was reported as an ictal sign in the majority of patients, and less frequently was reported as postictal. We believe that PIWD might be considered a rare automatic behaviour, like other automatisms. Automatisms are more frequently described in patients with temporal lobe epilepsy. PIWD was reported also to have lateralizing significance in the non-dominant temporal lobe, however, because of its rarity, this finding remains unclear.