Abdominal epilepsy in children

Abdominal epilepsy is an extremely rare epileptic syndrome that is more common in children. In abdominal epilepsy, seizure activity causes abdominal symptoms. For example, it can cause pain and nausea. Anticonvulsants may improve symptoms.

Abdominal epilepsy is so rare that some experts wonder if it exists. Abdominal pain is common in people with and without epilepsy. So it could be that the abdominal pain is just a coincidence and not caused by cramps.

What are the symptoms of abdominal epilepsy?

Little is known about abdominal epilepsy. In the past forty years, only 36 cases have been reported in medical journals.

Abdominal epilepsy is thought to cause seizures that primarily affect the digestive system. The result is gastrointestinal symptoms. 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 generalized tonic-clonic seizures

People with abdominal epilepsy have different symptoms. In addition, symptoms may vary from time to time in the same person. For example, during an attack, a person may have cramps and abdominal pain. Then a person can only have abdominal pain during the next attack.

What causes abdominal epilepsy?

Nobody knows what causes abdominal epilepsy. Because this disease is so rare, high-quality research does not exist. Too few cases have been reported to identify risk factors, genetics, or other potential causes.

How is abdominal epilepsy diagnosed?

Diagnosis of abdominal epilepsy may include arguments about the chicken or the egg. Epileptic seizures are sometimes preceded by symptoms. These symptom patterns are called auras. Just before a seizure, some people with epilepsy may feel something that isn't there. Others may see flashing lights.

Auras with abdominal symptoms are common in epilepsy. You can call it a guess. Nausea, pain, flatulence, or hunger may signal a crisis. But are abdominal symptoms already evidence of full-fledged seizures?

Some experts believe that the diagnosis of abdominal epilepsy should be made when abdominal symptoms are the primary manifestation of seizure activity.

They propose the following criteria for diagnosing 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 (for example, confusion or lethargy)
an abnormal electroencephalogram
sustained absence of abdominal symptoms while taking an epilepsy medication

Medical and neurologic testing might include:

computed tomography scans of the abdomen and brain
magnetic resonance imaging 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

What is the treatment for abdominal epilepsy?

Abdominal epilepsy is treated, like other forms of epilepsy, with anticonvulsants. Dilantin (phenytoin) is often used. However, since there are no controlled studies, other drugs may be just as effective.

In known cases of abdominal epilepsy, treatment with antiepileptic drugs has usually significantly reduced abdominal symptoms. However, this is not proof that the abdominal symptoms were caused by the seizures. Epilepsy drugs affect the nerves in general. They may simply relieve abdominal pain in this way or through a placebo effect.