Abdominal epilepsy, an uncommon cause of recurrent abdominal pain: a brief report
- Department of Medicine, Gauhati Medical College and Hospital, Bhangagarh, Guwahati, Assam, India
- Correspondence to:
Dr S Dutta
Department of Medicine, Gauhati Medical College and Hospital, Bhangagarh, Guwahati 781032, Assam, India;
Abdominal epilepsy is an uncommon cause of recurrent abdominal pain.1,2 It is characterised by paroxystic episodes of abdominal pain, diverse abdominal complaints, definite EEG abnormalities and favourable response to the introduction of epilepsy drugs.1
We describe four patients, with recurrent abdominal pain, without obvious associated symptoms suggestive of central nervous system abnormalities, but each had definite EEG abnormalities and a striking response to anticonvulsant drugs.
A 15-year-old boy presented with recurrent episodes of abdominal pain and vomiting for the past 12 years. The pain was localised in the epigastric region and its duration varied from 30 min to 1 h. The paroxysms were sudden in onset and subsided spontaneously. The episodes occurred every 3–4 months, and were followed by lethargy.
On investigating, the gastrointestinal barium study showed features suggestive of duodenal inversus.
While performing an exploratory laparotomy, it was noted that besides having intestinal malrotation, the patient also had multiple congenital bands with adhesions. Gastrojejunostomy and adhesionolysis were carried out.
During the postoperative follow-up, the patient again developed symptoms of abdominal pain and vomiting.
A CT scan of the brain was performed, which was normal. However, the EEG recording showed right temporal focal seizure discharge with generalisation, with diffuse cortical dysfunction in the form of slowing (fig 1). An MRI of the brain was performed, which was found to be normal.
The patient started treatment with oxcarbazepine and remained asymptomatic for 6 months. He again had a relapse of his symptoms. Doubting his compliance with the drug …