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Durch heißes Wasser reflektorisch ausgelöste Epilepsie

Kasuistik und Literaturübersicht

Hot water epilepsy

Case report and review of the literature

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Zusammenfassung

Die „hot water epilepsy“ (HWE) ist durch die reproduzierbare reflektorische Anfallsauslösung mithilfe von heißem Wasser charakterisiert und gehört in die Gruppe der Reflexepilepsien. Erstmals wurde 1945 über die HWE als Syndrom berichtet. Sie tritt bevorzugt, aber nicht ausschließlich in Indien auf. In Europa ist die HWE selten. Die Altersspanne der Betroffenen variiert laut Literatur vom 2. Lebensmonat bis zum 58. Lebensjahr bei einem Durchschnitt von 13 Jahren. Die meisten Patienten erleiden ihre Anfälle in der ersten Dekade ihres Lebens. Die Behandlungsprognose ist bei Kombination einer Expositionsprophylaxe und einer medikamentösen Therapie günstig. Spezifische Medikationsempfehlungen gibt es nicht. Es wird der ungewöhnliche Fall eines im Erwachsenenalter erkrankten deutschen Patienten berichtet, bei dem die Diagnose durch die Anamnese und den Beleg des Reflexmechanismus während des stationären Aufenthalts gestellt wurde. Unter Expositionsprophylaxe und einer niedrig dosierten Monotherapie mit Levetiracetam blieb der Patient anfallsfrei. Die Nachbeobachtungszeit beträgt bislang ein Jahr. Auch in Europa sollte man an solche ungewöhnlichen Mechanismen als ätiologische Möglichkeit denken. Ergänzend wird die aktuelle Literatur referiert.

Abstract

Hot water epilepsy (HWE) is characterized by the reproducible reflectory initiation of seizures by hot water and was described for the first time in 1945. It occurs mainly but not exclusively in India. Hot water epilepsy is rarely seen in Europe. It belongs to the large group of reflex epilepsies. The age of first manifestation varies widely with a range between 2 months and 58 years, mean age is 13 years. Most patients suffer from first seizures during the first decade of life. The treatment prognosis is usually good, if the precipitating factor is avoided and anticonvulsant drug treatment is initiated. Specific syndrome-related drug recommendations do not exist. The unusual case of a German adult who developed seizures at the age of 33 years is reported. The typical history and the proof of the reflex mechanism during hospitalization led to the diagnosis. He has remained seizure-free by avoiding triggering situations and under levetiracetam monotherapy with a follow-up of 1 year. In this paper, the authors draw attention to the possibility of such unusual reflex mechanisms and give a review of the literature.

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  1. Epilepsiezentrum Kork, Landstr. 1, 77694, Kehl-Kork, Deutschland

    R. Kornmeier &  B.J. Steinhoff

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Kornmeier, R., Steinhoff, B. Durch heißes Wasser reflektorisch ausgelöste Epilepsie. Z. Epileptol. 25, 56–59 (2012). https://doi.org/10.1007/s10309-011-0202-x

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