Abdominal epilepsy in children and adults
Abdominal epilepsy is a rare syndrome of epilepsy that is more likely to occur in children. With abdominal epilepsy, seizure activity causes abdominal symptoms. For example, it may cause pain and nausea. Anticonvulsant medicines can improve the symptoms.
What are the symptoms of abdominal epilepsy?
Little is known about abdominal epilepsy. There have only been 36 cases reported in medical journals in the last 40 years.
With abdominal epilepsy, it is thought that seizures occur that primarily affect the digestive system. Gastrointestinal symptoms are the result. These symptoms include:
- Abdominal pain, usually sharp or cramping and lasting seconds to minutes
- Nausea and/or vomiting
- Fatigue, lethargy or sleep following seizures
- Altered level of consciousness, such as confusion or unresponsiveness
- Convulsive seizures known as generalised tonic-clonic seizures
People with reported abdominal epilepsy have different patterns of symptoms. Also, symptoms may vary in the same person from one time to the next. For example, a person might have convulsive seizures and abdominal pain during one episode, but the next time they have a seizure they may only have abdominal pain.
What causes abdominal epilepsy?
No one knows what causes abdominal epilepsy. Because abdominal epilepsy is so rare, no high-quality studies exist. There have been too few reported cases to identify risk factors, genetic factors or other potential causes.
How is abdominal epilepsy diagnosed?
Diagnosing abdominal epilepsy can be difficult. Seizures in epilepsy are sometimes preceded by patterns of symptoms, called auras. Just before a seizure, some people with epilepsy might smell something that's not there. Others might see flashing lights.
Auras with abdominal symptoms are common in epilepsy and are like a “gut feeling”. Nausea, pain, flatulence or hunger can herald a seizure.
Experts suggest the diagnosis of abdominal epilepsy should be made when abdominal symptoms are the main manifestation of seizure activity.
They propose these criteria for the diagnosis of abdominal epilepsy:
- Periodic abdominal symptoms that can't be explained after extensive medical testing, including blood tests, imaging scans and endoscopy
- Symptoms that suggest a central nervous system problem such as confusion or lethargy
- An abnormal electroencephalogram (EEG)
- Sustained absence of abdominal symptoms while taking epilepsy medicine
Medical and neurological testing might include:
- Computed tomography (CT) scans of the abdomen and brain
- Magnetic resonance imaging ( MRI) scan of the brain
- Ultrasound of the abdomen
- Endoscopy of the gastrointestinal tract, either upper (through the mouth), lower (through the rectum) or both
- Blood tests
- Electroencephalogram (EEG)
What is the treatment for abdominal epilepsy?
Abdominal epilepsy is treated like other forms of epilepsy, with anticonvulsant medicines. Phenytoin is often used, but as no controlled studies exist, other medicines might be equally effective.
In the known cases of abdominal epilepsy, treatment with epilepsy medicines has usually significantly reduced abdominal symptoms.