Paroxysmal Abdominal Pain as a Manifestation of Epilepsy

Abstract

Paroxysmal abdominal pain as a form of epilepsy is a fairly well-established clinical entity. Several series of patients have been reported in which both the clinical and the eeg findings have been detailed. In only 1 of these cases, however, was an eeg recorded during an actual attack of pain. This report deals with the 2d instance in which modification of the eeg occurred with an episode of paroxysmal abdominal pain. The patient is a 9-year-old girl who has had recurrent episodes of peri-umbilical pain since the age of 5. These occurred at 5- to 6-week intervals and lasted about 5 days each. During the course of her study two eegs were taken between bouts of pain. These were interpreted as mildly abnormal because of some suggestive paroxysmal features. A 3d tracing was obtained during an attack. This consisted of partly synchronous high voltage 3 CPS waves in all leads. Another eeg obtained 2 days later when the pain had disappeared (the child was still subdued and withdrawn) showed occasional bursts of 3 CPS high voltage waves with large amounts of 4-6 CPS activity. A follow-up eeg taken 1 month later was considered essentially the same as the other interim tracings. Etiologic factors and possible mechanisms of abdominal seizures are discussed.