Abdominal epilepsy

Recently, Phu Tho Provincial General Hospital admitted a 31-year-old male patient (from Phu Tho) with symptoms including abdominal pain, nausea, vomiting, decreased consciousness, and difficulty communicating.

The patient's family reported that for the past two years, the patient has frequently experienced sudden, severe abdominal pain accompanied by vomiting, with each episode lasting several minutes. After the pain subsides, the patient often becomes lethargic and unconscious. Many episodes of abdominal pain are accompanied by urinary retention.

The patient has consulted several medical facilities, undergoing gastroscopy, colonoscopy, abdominal CT scan, and consultations with gastroenterologists, but the cause of the illness remains undetermined. The patient also consulted a mental health specialist, was diagnosed with somatoform disorder, and was prescribed four medications for anxiety and depression, but the abdominal pain did not improve. The pain tended to increase in frequency and intensity, sometimes reaching 10 episodes a day, with particularly severe pain after sleep deprivation.

Prior to this hospitalization, the patient experienced insomnia for two consecutive days, followed by continuous abdominal pain accompanied by vomiting, decreased consciousness after each pain episode, and difficulty communicating. Upon admission to Phu Tho Provincial General Hospital, the patient underwent paraclinical tests and consultations with gastroenterology specialists to rule out gastrointestinal diseases. Additionally, the patient underwent prolonged electroencephalography (EEG) immediately following the abdominal pain episodes, cranial MRI scans, neurological abnormalities assessment, and other specialized tests.

The patient with abdominal epilepsy recovered after a period of treatment.

PHOTO: BSCC

Based on the patient's medical history, pain characteristics, electroencephalogram (EEG) abnormalities, and cranial MRI images, the doctors consulted and diagnosed the patient with "abdominal epilepsy." Just two days after treatment, the patient responded to the local anticonvulsant medication regimen. After 14 days of treatment, the patient did not experience any recurrence of the previous seizures, was discharged, prescribed outpatient treatment, and scheduled for regular follow-up appointments.

According to MSc. Ta Van Hai, Deputy Head of the Neurology and Subacute Stroke Treatment Department at Phu Tho Provincial General Hospital, abdominal epilepsy is a rare disease that does not cause severe seizures but causes patients to experience gastrointestinal symptoms (abdominal pain, vomiting, or diarrhea), thus often being mistaken for digestive disorders, leading to delays in treatment. For the patient in question, if not detected and treated promptly, it can lead to many serious complications such as vomiting, abdominal pain, dehydration, electrolyte imbalance, altered consciousness, and other secondary complications affecting physical and mental health.

"Electroencephalography (EEG) is a core tool for diagnosing abdominal epilepsy, recording abnormal electrical activity in the brain. Extended EEG or video EEG (combined with video recording) helps determine the timing and characteristics of seizures, differentiating epilepsy from unrelated gastrointestinal disorders," said Master Hai.

MSc. Ta Van Hai noted that symptoms of abdominal epilepsy are often related to the digestive system (severe abdominal pain lasting from a few seconds to a few minutes; nausea and vomiting, which may occur suddenly and are not related to food; diarrhea or bloating, prolonged digestive disorders...). To diagnose, doctors will gather information about symptoms (frequency, duration, and characteristics of abdominal pain, vomiting, or diarrhea; history of epilepsy, head trauma, neurological disorders; triggering factors: stress, lack of sleep, or foods that may be related to the seizure).

Source: https://thanhnien.vn/dong-kinh-the-bung-185250930175225362.htm