Abstract
Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed us to make a diagnosis of focal epilepsy with ictal abdominal pain. This is a rare epileptic phenomenon that should be suspected in patients with unexplained paroxysmal abdominal pain and migraine-like symptoms. We suggest that, after the exclusion of more common etiologies, focal epilepsy with ictal abdominal pain should be considered in patients with paroxysmal abdominal pain and ictal EEG abnormalities.
Highlights
Recurrent episodes of abdominal pain are common in children and adults
We describe one child affected by epilepsy which had recurrent and severe abdominal pain as the only manifestation of epileptic seizures
Painful epileptic auras were reported in 4.1% of 25 patients with focal epilepsy by Nair et al [6]
Summary
Recurrent episodes of abdominal pain are common in children and adults. Several pathological conditions can lead to paroxysmal gastrointestinal symptoms, such as porphiria, cyclical vomiting, intestinal malrotation, peritoneal bands, and abdominal migraine [1]. In a number of patients the episodic nature of abdominal pain can be suggestive for a diagnosis of epilepsy [1]. Epileptiform EEG abnormalities, loss or alteration of consciousness, and a good response to antiepileptic drugs are other features that can lead to a diagnosis of focal epilepsy with ictal abdominal pain [2,3]. We describe one child affected by epilepsy which had recurrent and severe abdominal pain as the only manifestation of epileptic seizures. The boy experienced recurrent episodes of abdominal pain since about 6 months of. Interictal EEG during wakefulness and sleep displayed bilateral spikes and diphasic sharp-waves localized over the temporal leads with a marked increase in frequency during drowsiness. At 9:30 in the morning a seizure characterized by severe abdominal pain in the epigastric region with nausea and pallor was recorded. At the last follow-up, when he was 9-years old, he was seizure free
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