Abstract
Abdominal Epilepsy is a rare cause of recurrent abdominal pain in children. Paroxysmal episodes of pain abdomen with neurological symptoms like dizziness, post-ictal sleep or lethargy, specific electro-encephalographic changes and improvement in symptoms after treatment with antiepileptic drugs help in diagnosis of abdominal epilepsy. We report a seven-year-old girl with recurrent episodes of abdominal pain. Cause of pain remained undiagnosed despite extensive investigative workup. Meticulous history and pain diary gave clue to the diagnosis. EEG conducted during pain episode was abnormal. Treatment with Valproate resolved the pain. Normalization of EEG findings on follow up confirmed the diagnosis of abdominal epilepsy.
Highlights
Recurrent bouts of abdominal pain present the clinician with a diagnostic dilemma
Abdominal epilepsy is characterized by otherwise unexplained paroxysmal abdominal pain, other gastrointestinal complaint like vomiting, nausea, symptoms of disturbances of central nervous system like dizziness, lethargy, disorientation or post-ictal sleep, definite electroencephalogram abnormality and improvement on introduction of antiepileptic drugs [2,3]
We present a case of sevenyear-old girl with idiopathic abdominal epilepsy
Summary
Recurrent bouts of abdominal pain present the clinician with a diagnostic dilemma. Apley defines recurrent abdominal pain as "at least three episodes of abdominal pain, severe enough to affect their activities over a period longer than three months"[1]. A seven-year-old female child presented with complaint of recurrent abdominal pain for last 7 months. It was acute onset, colicky, mostly in periumbilical region, lasting for 1-3 hours, associated with vomiting 1-2 episodes. Peptic ulcer disease and reflux, many antispasmodics and analgesics but relief of pain was minimal with these drugs She was given trial of flunarizine and sumatriptan for two months with possibility of abdominal migraine but pain showed no improvement. Due to high suspicion of abdominal epilepsy, an EEG was done during pain episode. It revealed frequent generalized 4-5 Hz spike and wave, polyspike and wave discharges with bifrontal predominance (Fig).
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