Abdominal Epilepsy and Foreign Body in the Abdomen - Dilemma in Diagnosis of Abdominal Pain

Abstract

There are many medical causes of abdominal pain; abdominal epilepsy is one of the rarer causes. It is a form of temporal lobe epilepsy presenting with abdominal aura. Temporal lobe epilepsy is often idiopathic, however it may be associated with mesial temporal lobe sclerosis, dysembryoplastic neuroepithelial tumors and other benign tumors, arterio-venous malformations, gliomas, neuronal migration defects or gliotic damage as a result of encephalitis. When associated with anatomical abnormality, abdominal epilepsy is difficult to control with medication alone. In such cases, appropriate neurosurgery can provide a cure or, at least, make this condition easier to treat with medication.Once all known intra-abdominal causes have been ruled out, many cases of abdominal pain are dubbed as functional. If clinicians are not aware of abdominal epilepsy, this diagnosis is easily missed, resulting in inappropriate treatment. We present a case report of a middle aged woman presenting with abdominal pain and episodes of unconsciousness. On evaluation she was found to have an intra-abdominal foreign body (needle). Nevertheless, the presence of this entity was insufficient to explain her episodes of unconsciousness. On detailed analysis of her medical history and after appropriate investigations, she was diagnosed with temporal lobe epilepsy which was treated with appropriate medications, and which resulted in her pain being relieved.

Abdominal Epilepsy in Gov. Celestino Gallares Memorial Hospital

“…To date, the exact pathophysiology of abdominal epilepsy is unknown, but the most commonly seen underlying pathology is hippocampal sclerosis which is associated with febrile convulsions and subsequent development of complex partial seizures in late childhood or adolescence [8]. Other possible etiologies included temporal lobe tumors, malformations, bilateral perisylvian polymicrogyria, febrile seizures, neuroendocrine dysfunction, and prematurity [9].…”

Biopsychosocial approaches to a patient with vomiting of 10 years' duration – a case of temporal lobe epilepsy

“…Peppercorn [ 19 ] reported a case of abdominal epilepsy with temporal region EEG abnormality, in which the symptoms were nausea sustained for several hours and severe dizziness. Cases of abdominal pain in patients with epilepsy (abdominal epilepsy; a form of TLE) have also been reported [ 19 - 21 ]. To the best of our knowledge, there has not been an adult case report of persistent vomiting that continued for several days without alteration of consciousness.…”

Acute Diarrhea as a Manifestation of Abdominal Epilepsy

“…There are 36 cases reported in literature, in the review of abdominal epilepsy by Zinkin and Peppercorn [4]. We found other 15 cases of abdominal epilepsy in English literature after Zinkin's review paper [6][7][8][9][10][11][12][13][14][15][16]. In the reported cases, there is no racial specificity nor regional specificity.…”