A pain fired from brain: Abdominal Epilepsy

By, Dr. Sc. Brunilda ZLLAMI, MD. Stavri LLAZO, Dr. Sc. Entela BASHA, Prof. Asoc. Dr. Voltisa GJERGJI

Abstract
Introduction: Abdominal pain is a nonspecific symptom which can be caused by a constellation of pathologies. It can be related sometimes to pathologies that affect the brain and mind. Among pathological conditions that can cause paroxysmal gastrointestinal symptoms are porphyria, abdominal migraine, cyclical vomiting, intestinal malrotation and peritoneal bands. Among them, rare, but important to recognize is abdominal epilepsy. Abdominal epilepsy is more a diagnosis of exclusion, and it is considered to be part of the group of temporal lobe epilepsies, which usually occur in children. However rare, there is recorded documentation of its occurrence even in adults. Method: We present two adult case reports with abdominal symptoms who have undergone several investigations before the diagnosis. Results: In these patients the pellicular combination of the irregular paroxysm of abdominal pain, combined with symptoms involving the central nervous system and the exclusion of pathologies that can produce similar symptoms can guide the physician to the diagnosis of abdominal epilepsy. Discussion: It should be suspected abdominal epilepsy when we encounter unexplained and recurrent gastrointestinal symptoms such as severe paroxysmal pain, hunger, flatulence, nausea and sometimes diarrhea. Symptoms are associated with central nervous system symptoms such as lethargy, confusion or alteration of consciousness and are improved with antiepileptic therapy. This diagnosis is usually associated with electroencephalography changes. The symptoms are quite vague and
for this reason it is difficult to make a diagnosis.
Keywords: abdominal epilepsy, unexplained abdominal pain, EEG, adults, antiepilepsy drug therapy, case report