Late-Onset Abdominal Epilepsy with an Uncommon Epileptic Focus: A Case Report
Abstract
Background: Abdominal epilepsy (AE) is a rare disorder characterized by recurrent abdominal pain and electroencephalography (EEG) abnormalities indicating seizure activity. It is mainly a disease of youngsters and originates from the temporal lobe. Case Report: This case describes a 58-year-old woman with episodes of diffuse abdominal pain and altered consciousness. Her episodes were associated with disorientation and reduced consciousness. Extensive gastrointestinal investigations revealed no underlying cause; however, the EEG showed epileptiform activity in the frontal regions of both hemispheres. After exclusion of other causes, AE was diagnosed, and treatment with levetiracetam was initiated. Six months later, the patient showed significant improvement and did not have a recurrence of episodes. Conclusion: AE should be suspected not only in youngsters but also in adults who demonstrate recurrent abdominal symptoms that are accompanied by neurological signs. Temporal origin is not a rule, and extratemporal origin may be the culprit as well.
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References
- 1. Franzon RC, Lopes CF, Schmutzler KMR, Morais MIR, Guerreiro MM. Recurrent abdominal pain: when should an epileptic seizure be suspected? Arq Neuropsiquiatr. 2002;60(3- A):628-30. doi:10.1590/s0004-282x2002000400021.
- 2. Solana de Lope J, Alarcón Fernández O, Aguilar Mendoza J, Beltrán Coronel J, Barinagarrementería F, Pérez Manauta J. Epilepsia abdominal en el adulto [abdominal epilepsy in the adult]. Rev Gastroenterol Mex. 1994;59(4):297-300.
- 3. Zinkin NT, Peppercorn MA. Abdominal epilepsy. Best Pract Res Clin Gastroenterol. 2005;19(2):263-74. doi:10.1016/j. bpg.2004.10.001.
- 4. Kraimer KL, Kochanski RB, Lynn F, Smith M, Sani S. Abdominal epilepsy treated with vagal nerve stimulation: a case report. Oper Neurosurg. 2019;17(2):E73-6. doi:10.1093/ons/opy295.
- 5. Balabhadra A, Malipeddi A, Ali N, Balabhadra R. Abdominal epilepsy: a rare cause of unexplained abdominal pain. Cureus. 2020;12(8):e10120. doi:10.7759/cureus.10120.
- 6. Abdelfatah HMM, ElAgamy MMM. Recognizing and diagnosing abdominal epilepsy in adult male case study. J Psychiatry Psychiatr Disord. 2023;7(1):21-4. doi:10.26502/ jppd.2572-519X0180.
- 7. Nayak CS, Bandyopadhyay S. Mesial temporal lobe epilepsy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan- [updated 2023 May 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554432/.
- 8. Dash D, Tripathi M. The extratemporal lobe epilepsies in the epilepsy monitoring unit. Ann Indian Acad Neurol. 2014;17(Suppl 1):S50-5. doi:10.4103/0972- 2327.128655.
- 9. Schäuble B, Castillo PR, Boeve BF, Westmoreland BF. EEG findings in steroid-responsive encephalopathy associated with autoimmune thyroiditis. Clin Neurophysiol. 2003;114(1):32- 7. doi:10.1016/s1388-2457(02)00343-7.
- 10. Karroumi S, Ennaciri Z, Adali I, Manoudi F. Abdominal epilepsy: a rare entity revealed by a depressive syndrome. American Journal of Psychiatry and Neuroscience. 2024;12(2):28-31. doi:10.11648/j.ajpn.20241202.11.