Abdominal epilepsy

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Abdominal epilepsy
Classification and external resources
ICD-9 345.5
MeSH D004828

Abdominal epilepsy, also known as autonomic epilepsy, is a rare condition most frequently found in children, consisting of gastrointestinal (GI) disturbances caused by epileptiform seizure activity.[1][2][3][4][5]

It has been described as a type of temporal lobe epilepsy.[6] Responsiveness to anticonvulsants can aid in the diagnosis.[7]

Most published medical literature dealing with abdominal epilepsy is in the form of individual case reports. A 2005 review article found a total of 36 cases described in the medical literature.[3]

Symptoms[edit]

The most common symptom of abdominal epilepsy is abdominal pain followed by uncontrollable vomiting, usually preceded by lethargy. Symptoms also include generalized tonic-clonic seizures followed by sleep, confusion, and unresponsiveness.[8]

Cause[edit]

No one knows what causes abdominal epilepsy. While a causal relationship between seizure activity and the GI symptoms has not been proven, the GI symptoms cannot be explained by other pathophysiological mechanisms, and are seen to improve upon anticonvulsant treatment. Because the condition 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.[8]

Diagnosis[edit]

Criteria for diagnosis of abdominal epilepsy includes frequent periodic abdominal symptoms, an abnormal electroencephalogram (EEG) and significant improvement of gastrointestinal symptoms after taking anti-seizure medication. Medical testing for diagnosis can be completed using MRI scans of the brain, CT scans and ultrasounds of the abdomen, endoscopy of the gastrointestinal tract, and blood tests.[8]

Treatment[edit]

Like other forms of epilepsy, abdominal epilepsy is treated with anticonvulsant drugs, such as Dilantin (phenytoin). Since no controlled studies exist, however, other drugs may be equally effective.[8]

History[edit]

Trousseau is commonly credited as the first to describe the condition in 1868 in a boy with paroxysmal GI symptoms culminating in grand mal epileptic seizure.[9] The first account of abdominal epilepsy supported by EEG tracings came in 1944 in an article by M.T. Moore, followed by subsequent case reports from the same group.[10][11]

References[edit]

  1. ^ Dutta SR, Hazarika I, Chakravarty BP (March 2007). "Abdominal epilepsy, an uncommon cause of recurrent abdominal pain: a brief report". Gut 56 (3): 439–41. doi:10.1136/gut.2006.094250. PMC 1856820. PMID 17339252. 
  2. ^ Eschle D, Siegel AM, Wieser HG (December 2002). "Epilepsy with severe abdominal pain". Mayo Clin. Proc. 77 (12): 1358–60. doi:10.4065/77.12.1358. PMID 12479525. 
  3. ^ a b Zinkin NT, Peppercorn MA (April 2005). "Abdominal epilepsy". Best Pract Res Clin Gastroenterol 19 (2): 263–74. doi:10.1016/j.bpg.2004.10.001. PMID 15833692. 
  4. ^ Levendorf M (January 2000). "Chronic abdominal pain and abdominal epilepsy". Am Fam Physician 61 (1): 50. PMID 10643951. 
  5. ^ Peppercorn MA, Herzog AG (October 1989). "The spectrum of abdominal epilepsy in adults". Am. J. Gastroenterol. 84 (10): 1294–6. PMID 2801681. 
  6. ^ Topno N, Gopasetty MS, Kudva A, B L (December 2005). "Abdominal Epilepsy and Foreign Body in the Abdomen - Dilemma in Diagnosis of Abdominal Pain". Yonsei Med. J. 46 (6): 870–3. doi:10.3349/ymj.2005.46.6.870. PMC 2810606. PMID 16385668. 
  7. ^ Singhi PD, Kaur S (April 1988). "Abdominal epilepsy misdiagnosed as psychogenic pain". Postgrad Med J 64 (750): 281–2. doi:10.1136/pgmj.64.750.281. PMC 2428499. PMID 3186570. 
  8. ^ a b c d "Abdominal Epilepsy in Children and Adults". Epilepsy Health Center. WebMD. 18 March 2013. Retrieved 13 February 2014. 
  9. ^ "Abdominal epilepsy". 1989. 
  10. ^ M.T. Moore, "Paroxysmal abdominal pain: a form of focal symptomatic epilepsy", JAMA.1944 124 561-563
  11. ^ MOORE MT (July 1950). "Abdominal epilepsy versus "abdominal migraine"". Ann. Intern. Med. 33 (1): 122–33. doi:10.7326/0003-4819-33-1-122. PMID 15426097.