Table 1 Clinical characteristics of reported cases of abdominal epilepsy in pediatric population and in our patient
From: Focal epilepsy with ictal abdominal pain: a case report
Patient number | Age | Sex | Gastrointestinal symptoms | Other non-gastrointestinal symptoms | Episode duration | EEG | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|
Zdravescka N. et al. 1 | 14 | F | Colicky epigastric pain, nausea, vomiting and diarrhea | Pallor, dizziness | 10-30 minutes | Spikes, sharp waves over the right central and temporal regions with secondary generalization | Carbamazepine | Seizure free |
Franzon RC et al. 2 | 6 | F | Abdominal pain | Disturbed awareness, occasional generalized tonic-clonic seizures | Seconds to minutes | Spikes and slow waves over left temporal area | Anticonvulsants, surgical resection of oligoastrocytoma | Seizure free |
Garcia-Herrero D. et al. 3 | 14 | F | Colicky periumbilical pain | Headache, pallor, dizziness, multicolored photopsia | Second to minutes | Interictal-bursts of sharp and slow waves | Valproic acid | Near complete resolution |
Dutta SR et al. 4 | 15 | M | Epigastric abdominal pain and vomiting | Lethargy | 30 minute to hours | Right temporal focal seizure discharge with generalization | Oxcarbazepine | Seizure free |
Case 1 | ||||||||
Dutta SR et al. 4 | 13 | F | Colicky periumbilical pain | NR | 10-30 minutes | Generalized spikes and wave discharges | Oxcarbazepine | Seizure free |
Case 2 | ||||||||
Young GB et al. 5 | 15 | F | Abdominal pain | Generalized tonic seizures | NR | Multiple independent spikes | NR | NR |
Hasan N. et al. 7 | 8 | M | Colicky periumbilical pain, vomiting | Pallor, an episode with jerky movements in the lower limbs | 10-30 minutes | Generalized paroxysmal epileptiform activity, maximum on photic stimulation | Valproic acid | Seizure free |
Siegel AM et al. 8 | 1 | F | Crampy periumbilical pain | Occasional generalized seizures | Few seconds | Right parietal focus | NR | NR |
Mitchell WG et al. 9 | 6 | M | Vomiting | Bad smell, fatigue | 20-40 seconds | Ictal and intercritic high voltage arrhythmic delta waves, sometimes sharply contoured | Multiple antiseizure medication, than surgary and radiation (for astrocytoma) | Decreased frequency of episodes |
Douglas EF et al. 10 | 11 | F | Paroxysmal, peri-umbilical abdominal pain | Lassitude, post-ictal sleep, fever, headache, confusion. | “Brief” | Irregular 3 Hz spike-waves activity | Phenobarbital | Seizure free |
Case 1 | ||||||||
Douglas EF et al. 10 | 5 | F | Crampy, paroxysmal abdominal pain | Lethargy, post-ictal sleep | Few minutes | Episode 6–7 activity in L temporal area, burst of generalized irregularly intermixed spikes and slow waves | Phenobarbital | Lost to follow-up |
Case 2 | ||||||||
Douglas EF et al. 10 | 6 | M | Paroxysmal pain | Lethargy, confusion, fever | Few minutes | Paroxysmal spike-wave activity, frontal or generalized | Anticonvulsivants | Seizure free |
Case 3 | ||||||||
Yingkun F 11 | 3 | M | Abdominal pain, vomiting | Confusion, cyanosis, urinary incontinence, blindness | Few minutes | Scattered high voltage slow activity and high voltage sharp waves | Phenytoin, phenobarbital | Seizure free |
Case 1 | ||||||||
Yingkun F 11 | 16 | M | Upper abdominal pain, nausea | Disturbance of consciousness | 3-5 minutes | High voltage slow waves; high voltage sharp waves with hyperventilation | Phenobarbital | Seizure free |
Case 2 | ||||||||
Yingkun F et al. 11 | 11 | F | Periumbilical abdominal pain | Disturbance/loss of consciousness | Minutes to hour | Bilateral high voltage spikes, complexed slow waves | Phenytoin, phenobarbital | Seizure free |
Case 3 | ||||||||
Singhi PD et al. 12 | 10 | M | Periumbilical pain | Pallor, sweates, lethargy, post-ictal sleep | Few minutes | Sharp spikes, spikes and wave activity arising over the central region and becoming generalized | Phenytoin | Complete resolution |
Agrawal P. et al. 13 | 6 | M | Colicky periumbilical pain | Lassitude, post-ictal sleep | Half an hour | Generalized slowing, right posterior spikes | Carbamazepine | Seizure free |
Our patient | 8 | M | Colicky epigastric pain, nausea | Pallor | Few minutes to 1 hour | Bilateral synchronous and asynchronous spikes and diphasic sharp-waves in temporal and central area, increased during drowsiness and sleep | Carbamazepine | Seizure free |