Electroencephalography in Children with Recurrent Abdominal pain

Abstract

There has been a recent revival of interest in the possibility that some attacks of sudden abdominal pain in children may be examples of "masked epilepsy" (see Pediatrics, 15:705, 1955). The diagnosis of abdominal epilepsy has been based on such criteria as attacks of abdominal pain followed by exhaustion and sleep; a favorable clinical response to treatment with anticonvulsants; and electroencephalographic records considered characteristic of epilepsy. The present report comments upon the small number of reported cases and the lack of normal controls. As part of an investigation into the cause of recurrent abdominal pains in children, the authors studied the findings in electroencephalograms. The proportion of electroencephalograms considered typical of epilepsy in a group of 133 children with recurrent abdominal pains, but without demonstrable organic diseases, and in 133 children of corresponding ages without abdominal pains, was almost identical. The authors' findings do not support the view that there is a relationship between epilepsy and recurrent abdominal pains in childhood. They suggest that the supposed causal relationship between abdominal pains and cerebral dysrhythmia may have been based on a failure to compare electroencephalograms of children having those manifestations with electroencephalograms of apparently normal children. The authors realize that a small number of children with epilepsy also have recurrent abdominal pains, but feel that abdominal pain as a sole manifestation of epilepsy must be rare. These considerations may also apply to the point of view expressed by some, that cyclic vomiting is a form of "masked epilepsy."