Abdominal Epilepsy: An Uncommon of Non-Convulsive Status Epilepticus
Somsak Tiamkao MD*, Thongchai Pratipanawatr MD**, Suthipun Jitpimolmard MD*
Affiliation : * Division of Neurology, Deparment of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Division of Endocrinology, Deparment of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : To recognize abdominal epilepsy in adults.
Material and Method: Case report.
Results : Case 1: A 21-year-old woman with DM type I presented with a 2-month history involving four episodes of severe
abdominal pain and vomiting, each of which lasted four to five days. She had a recurrence every two weeks. The EEG
revealed ‘spike and wave’ and she was started an intravenous phenytoin that resolved the symptoms. Case 2: A 20-year-old
woman with DM type I was admitted with a 2-month history of recurring severe left upper quadrant pain associated with
occasional nausea but no vomiting. She experienced two more episodes of generalized tonic-clonic seizures and was treated
with 300 mg phenytoin given orally. The abdominal pains gradually subsided and she was symptom-free within two days. An
EEG showed frequent sharp waves. She was treated with 10 mg intravenous diazepam and her symptoms and sharp waves
disappeared within two minutes. Case 3: A 46-year-old man with DM type I was admitted with a four-month history of
recurring severe epigastric pain and vomiting. His physical examination, laboratory tests, and extensive investigation for a
primary GI disorder revealed nothing unusual. The EEG revealed spike and wave and he was treated with intravenous AED
(phenytoin) loading after which the symptoms disappeared.
Conclusion : Physicians should consider abdominal epilepsy in diabetics with recurrent, intractable abdominal pain in whom
extensive investigations for primary gastrointestinal (GI) disorders are unremarkable.
Keywords : Abdominal epilepsy, Non-convulsive status epilepticus, Abdominal pain
