Epileptic seizures in a patient by immersing his right hand into hot water

We report on a 22-year-old assistant cook, presenting with seizures evoked by immersing his right hand into hot water of 40-46 OC. His seizure pattern consisted of either simple partial seizures of a tingling sensation arisin g in the right hand and marching to the right shoulder or a similar attack evolving to a complex partial seizure. Video-EEG monitoring recorded habitu al seizures originating from the left centro-temporo-parietal region, compa tible with lesions seen on brain magnetic resonance imaging. He responded w ell to antiepileptic drug treatment and wearing gloves while working in the kitchen. In this patient, hot water of 30-46 DC could maximally stimulate skin warm thermoreceptors in the right hand whereby afferent impulses subse quently activated the epileptogenic focus, adjacent to or in the sensory co rtex, and elicited seizures. (C) 2000 BEA Trading Ltd.