We report on monozygotic twins with neonatal onset of daily reflex seizures 
triggered by hot water. Video record during the hot water bathing showed 
clinical signs consistent with a reflex seizure. The numbers of episodes were 
markedly reduced when the mother began bathing the children with reduced 
temperature bath water. At the age of 20 months, the twins developed episodes of 
paroxysmal disturbances including alternating hemiplegia. These two patients are 
the youngest reported cases of reflex hot water seizures, and the only reported 
cases in which reflex hot water seizures subsequently manifested episodes of 
alternating hemiplegia.