OBJECTIVES: Hot water epilepsy (HWE) or bathing epilepsy is one of the reflex 
epilepsies induced by hot water pouring over the head, face, neck, or trunk 
during bathing. The aim of this study was to demonstrate the clinical and 
electroencephalographic features and the management alternatives of the patients 
with HWE.
METHODS: The age of seizure onset, duration of seizure, family history, 
interictal and postictal electroencephalography findings, triggering temperature 
of water, type of seizure, medication, and follow-up results were evaluated for 
each patient.
RESULTS: The mean age at seizure onset was 10.5 years. The mean duration of 
seizures was 10 years. Interictal EEG recordings showed focal abnormalities in 4 
patients and generalized abnormalities in 3 patients. Only one patient had 
normal interictal EEG findings. Among the 8 patients with HWE, 6 had seizures 
only during hot bathing, whereas 2 had additional seizures. Seven patients had 
generalized tonic-clonic seizures and 1 patient had complex partial seizure 
during their hot bathings. The mean triggering temperature of water was 
calculated as 41.4 degrees C. The mean duration of follow-up period was 23 
months. Five patients became seizure-free during the follow-up period and 
seizures persisted in 3 patients. Antiepileptic drugs were given (800 mg/d 
carbamazepine for 2 patients and 600 mg/d phenytoin for 1 patient) to these 3 
patients and they also became seizure-free during the follow-up period.
CONCLUSIONS: Hot water epilepsy is a benign reflex epilepsy. Lowering water 
temperature must be the first step for the treatment. If needed, antiepileptic 
drugs should be considered as an additive treatment.