OVERVIEW
Abdominal epilepsy is a type of epilepsy characterized by episodes of transient abdominal pain. In this disease, the abdominal pain is recurrent and periodic, lasting from a few minutes to a few hours, with abrupt onset and termination. The pain is mostly around the umbilicus, but may also involve the epigastrium, and is often accompanied by nausea, vomiting, and diarrhea. There is no loss of consciousness during the episodes, but there is often some degree of disorientation, mental confusion and other changes. The etiology of the disease is unknown, and it occurs mostly in children and rarely in adults.
Etiology
The cause of the disease is not clear, but may be related to paroxysmal discharges in the mesencephalon or temporal cortex due to some kind of focal stimulation.
Symptoms
The disease is most common in children, and its onset can often be traced back to infancy. It is rarer in adults. There is no significant difference in the incidence between men and women. It is characterized by sudden onset of abdominal pain, mostly around the umbilicus and the upper abdomen, and in a few cases it may radiate to the lower abdomen and the abdominal flanks. The pain is often severe, such as a colic or a knife cut, and lasts for a few minutes, or more than a few hours. Seizures are often accompanied by a certain degree of impaired consciousness, such as disorientation, perceptual disorders or mental blurring, but there is no complete loss of consciousness. It is often accompanied by gastrointestinal symptoms such as loss of appetite, nausea, vomiting and diarrhea. There may also be other symptoms of vegetative dysfunction, such as pallor, flushing of the skin, sweating, unstable blood pressure, hypothermia or fever, vertigo, and syncope.
Most patients are tired, drowsy or deeply asleep after the attack. Wake up feeling well. Attacks can often occur several times over several days. In between episodes of abdominal pain, other paroxysmal symptoms, such as paroxysmal headaches, and a variety of behavioral disturbances may occur. Some patients have early paroxysmal abdominal pain seizures that later develop into epileptic convulsive seizures.
Examination
Abnormalities seen on EEG include paroxysmal fast or slow waves, and diffuse fast or slow waves. EEG shows focal temporal lobe changes that are typical of the disease.
Diagnosis
For obvious clinical symptoms such as recurrent paroxysmal abdominal pain, accompanied by a certain degree of impaired consciousness, no organic lesions in the abdomen are found after various examinations, combined with electroencephalography, the possibility of this disease needs to be considered.
Differential diagnosis
1. Acute abdomen
Abdominal pain is persistent and paroxysmal, often accompanied by fever, abdominal pressure, abdominal muscle tension, peripheral blood leukocytes are increased.
2. Intestinal roundworm
Abdominal cramps are paroxysmal, with intermittent relief, and roundworm masses can be found in the middle of the abdomen, and there is often a history of spitting roundworms and discharging roundworms.
Treatment
1. Antiepileptic drug treatment
It has better effect. Commonly used antiepileptic drugs include phenytoin sodium, amidostimine, phenobarbital, paracetamol, sodium valproate, etc., of which the preferred drug is phenytoin sodium.
2. Acupuncture treatment
Fengchi, Fengfu, Baihui, Shangxing, Yintang, Hatou, Quchi, Neiguan, Hegu, and other acupuncture points are often chosen.
Prognosis
The prognosis of this disease is generally good. Most patients have a tendency to spontaneous remission, and individual frequently recurring seizures can develop into typical convulsive seizures.