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When a child has frequent stomachaches and other gastrointestinal (GI) symptoms like bloating or vomiting, most people wouldn’t guess epilepsy as a cause. In some children, these may be symptoms of abdominal epilepsy. Abdominal epilepsy is an uncommon type of epilepsy that affects children and adolescents at higher rates than adults.
It can take time for doctors to diagnose abdominal epilepsy because it’s marked by abdominal symptoms rather than typical seizure symptoms. As a result, it’s often overlooked or misdiagnosed. In this article, we’ll discuss abdominal epilepsy symptoms and causes, plus treatments that may help.
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Abdominal epilepsy is a very rare type of focal seizure that often involves the temporal lobe. This form of epilepsy is most frequently seen in children ages 5 to 15, but adults can also have abdominal epilepsy. In abdominal epilepsy, abnormal electrical activity usually occurs in the brain’s temporal lobe, an area of the brain by the temples.
Abdominal epilepsy causes abdominal pain and other GI symptoms, such as nausea, bloating, and cyclic vomiting. These can appear alongside more typical signs of a seizure, like reduced consciousness.
Abdominal epilepsy is far more common in children and adolescents than in adults, though it’s still considered a rare form of epilepsy. While the data is limited, researchers estimate that between 1 percent and 5 percent of children with epilepsy have this type.
Abdominal epilepsy may be slightly more common in boys than girls, although more studies are needed to confirm this.
Researchers have linked abdominal epilepsy to unusual electrical activity in areas of the brain that control the autonomic nervous system. This part of the nervous system controls functions you don’t consciously think about, such as your digestion, heart rate, and blood pressure.
The cause of abdominal epilepsy isn’t clear, but it can sometimes be linked to a structural issue in the brain, such as a tumor, vascular malformation, scarring from a prior stroke or brain injury, or hippocampal sclerosis. However, much of the time, the cause is unknown.
Researchers also believe that certain genetic and environmental factors might trigger abdominal epilepsy, including:
Symptoms of abdominal epilepsy may include:
Someone may experience one or more of these symptoms at the same time.
One member of MyEpilepsyTeam diagnosed with abdominal epilepsy described their seizures:
“Before I was medicated, I was in and out of the ER monthly. I was constantly throwing up. I couldn’t hold down any food. I was in pain and became severely underweight. During the episode, I was throwing up, fainting, having convulsions, mentally in distress, and sensitive to light. This would last hours to multiple days.”
Symptoms of abdominal epilepsy are similar to irritable bowel syndrome (IBS). Unlike IBS, abdominal epilepsy may also involve altered consciousness during some (but not necessarily all) of the episodes.
This can look like confusion, jerking movements, or unresponsiveness. People with abdominal epilepsy also tend to be tired after an episode.
Diagnosing abdominal epilepsy can be a long and complicated process. Someone may start with primary care doctors but end up seeing several specialists to rule out other conditions.
The first step toward an abdominal epilepsy diagnosis is a physical examination by a doctor. Because of the gastrointestinal symptoms associated with this disease, people may first seek the help of a gastroenterologist, or GI specialist.
A gastroenterologist may perform a thorough examination and order tests to rule out common abdominal conditions.
A neurologist may be better at recognizing the signs and symptoms of abdominal epilepsy. They may first order a CT or MRI scan to rule out any structural problems in the brain. They may also order blood tests and carefully consider your symptoms.
An electroencephalogram (EEG) can be a key tool used to make a diagnosis. An EEG measures electrical activity across the brain. It’s useful for determining if there is seizurelike activity in the brain.
Someone with abdominal epilepsy may show abnormalities on their EEG.
Sometimes, people with abdominal epilepsy may be referred to a psychiatrist because GI symptoms can also be a sign of psychological distress instead of a physical health issue.
Children may also show changes in behavior but can’t communicate all their symptoms to their caregivers or doctors.
Although abdominal epilepsy often involves the temporal lobe, it can also originate in other parts of the brain. Temporal lobe epilepsy usually consists of two types of focal (partial) seizures: focal preserved consciousness seizures and focal impaired consciousness seizures.
Hallmark signs of focal preserved consciousness seizures include unusual feelings such as déjà vu, anxiety, a rising sensation in the abdomen (like being on a roller coaster), or other such sensory events.
Focal impaired consciousness seizures include symptoms such as loss of consciousness and repetitive behaviors, sometimes followed by a period of confusion and difficulty speaking. Sometimes, temporal lobe epileptic seizures can turn into generalized tonic-clonic seizures.
Although abdominal epilepsy doesn’t have the same characteristic symptoms as temporal lobe epilepsy, it can still show similar EEG activity patterns in or near the temporal lobe.
Treatment for abdominal epilepsy is similar to that of other forms of epilepsy. Doctors may recommend anti-seizure medications, benzodiazepines, or other medications used for focal epilepsy.
Examples of medications that have been used to treat abdominal epilepsy include:
Valproate (also called valproic acid and sodium valproate) is a common anti-seizure medication that can be prescribed for abdominal epilepsy. This medication can cause serious birth defects if taken during pregnancy. People who are pregnant or could become pregnant should discuss the risks and benefits with their doctor.
Unfortunately, there are no studies that compare the effectiveness of these medications for abdominal epilepsy. Work with your doctor to find a safe and effective treatment option.
One possible treatment option may be vagus nerve stimulation (VNS), which involves implanting a device near the vagus nerve to help control seizures. The vagus nerve is an important connection between the brain and the rest of the body and is part of the autonomic nervous system.
In a case study with a teenager with abdominal epilepsy, their abdominal seizures went from an average of 16 per month to an average of two per month with VNS treatment.
VNS is used to control seizures in people who don’t respond to medication. As of this writing, there aren’t large studies to support its effectiveness in people with abdominal epilepsy.
Currently, there is no cure for abdominal epilepsy. Research suggests that abdominal epilepsy can resolve on its own, especially in children. However, it’s unclear what factors may influence this.
Many people respond to first-line medication treatments and experience a significant reduction in their symptoms. The key to having a good outlook for abdominal epilepsy is coming to a diagnosis quickly and beginning treatment as soon as possible. It’s also important to follow up regularly with your doctor.
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I’m wondering if my daughter has this. Are you more likely to have it if your parent does? I have temporal lobe epilepsy.
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I was diagnosed with Abdominal Epilepsy when I was seven years old at Boston Children 's Hospital. I am a 67 years old female, and have suffered many years with migraines, and nausea. My illness went… read more
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