Abdominal epilepsy (AE). It is a rare disorder in which various gastrointestinal complaints including abdominal pain, nausea, vomiting result from seizure activity.
1 It is characterized by paroxysmal episodes of gastrointestinal complaints, definite electroencephalogram (EEG) abnormalities, and good response to antiepileptic drugs (AED) According to International League Against Epilepsy, AE are considered as a part of simple or complex partial seizures.
2 The pathophysiology of AE remains unclear.
1,3 A high index of suspicion is needed to make a diagnosis of AE after excluding all other possible causes.
3 The patients who have unexplained gastrointestinal complaints with or without central nervous system (CNS) features should be evaluated with EEG and if EEG is abnormal, should be given a trial of anticonvulsant drugs and the response should be carefully looked for. Usually, low dose single drug is required to control the disease.
3 Our child had unexplained paroxysms of vomiting. History of aura or post ictal symptoms like exhaustion or sleep were not reported in our child. Past history of febrile seizures, CNS infections and trauma are important histories in case of epilepsy which were not found in our patient.
4 Patients usually have temporal lobe seizure activity although extratemporal epilepsy has also been reported.
4 Our child also had abnormal EEG with involvement of occipital lobe. Various neurologic clues such as mental changes are observed along with abdominal complaints though every episode may not be accompanied with neurological symptoms. In our patient, there were less complaints of neurological manifestations.
3 For management of AE various drugs have been used like phenobarbital, carbamazepine, phenytoin, and
Valproic acid but there are no defining recommendations on the drug selection.
3 Our patient was started on
Flunarizine and showed gradual favorable and significant improvement.
| References : |
- Mondal R, Sarkar S, Bag T, Mondal K, Saren A. A pediatric case series of abdominal epilepsy. World J Pediatr. 2014;10:80-82.
- Mpondo BC, Mwasada G, Nyundo AA. Abdominal epilepsy, an uncommon cause of chronic and recurrent abdominal pain: a case report. Clin Case Rep. 2016;4:1117-1119.
- Jagtap SS, Wingkar KC, Aundhkar C, Boral S, Jagtap SV. Role of EEG in Diagnosing Abdominal Epilepsy Patients. J Clin Diagn Res. 2018;12:CC05-CC07
- Kshirsagar VY, Nagarsenkar S, Ahmed M, Colaco S, Wingkar KC. Abdominal epilepsy in chronic recurrent abdominal pain. J Pediatr Neurosci. 2012;7:163-166.
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