Narayana Hrudayalaya Multispecialty Hospital’s paediatric neurology department which is part of the healthcare major's Health City initiative has successfully treated a rare case of abdominal epilepsy.

The patient was a 7-year-old girl from South Kanara district was recently admitted for complaints of intermittent and later persistent severe abdominal pain. All investigations and scans of the abdomen were normal. She subsequently developed behavioural changes characterized by confusion, inappropriate response, episodic fear and screaming and for nearly 2 weeks had stopped even speaking.

The child was evaluated and treated by a team of doctors led by Dr Netravathi Ellur (Neurologist), Dr Minal Kekatpure (Paediatric Neurologist) and Dr Rajesh Iyer (Epileptologist). Her MRI brain was normal while the fractionated benzodiazepine test showed a mild improvement in her response raising possibility of seizures. A video-EEG showed that there were frequent complex partial seizures arising from the temporal lobes. The child was diagnosed to have Abdominal Epilepsy progressing to Complex Partial Status epilepticus.

The child was treated with high doses of antiepileptic medications after which became conscious and started speaking and was able to consume food by the 3rd day. She got discharged after 2 weeks in a perfectly normal state.

Abdominal epilepsy is a rare condition and is a type of epileptic aura that arises in the parietal or temporal lobes of the brain. Routine investigations for abdominal pain are negative while the EEG is diagnostic. Since there are no jerky movements and consciousness may also be preserved, a high index of suspicion is required to diagnose epilepsy as a cause for abdominal pain. Many cases of abdominal epilepsy could also be wrongly diagnosed as psychogenic pain also. Early recognition and aggressive treatment of such cases could help progression to status epilepticus and irreversible brain injury.

Epilepsy is a common disease of the brain affecting 0.5% of the Indian population. In 50% of these patients, a definitive cause can be detected, whereas in the rest, the cause is often unknown. One in 20 among the general population suffers an epileptic attack at some point during their lifetime. After the new onset of seizures, over 60% of patients develop recurrences. In general, following a first seizure attack, treatment decisions are made depending on the EEG and brain scan, according to the medical experts.

Usually epileptic fits are generally considered to be violent jerks of limbs with loss of consciousness. There are several types of epilepsies and jerky movements happen only in some types of seizures. In children, continuous or recurrent abdominal pain and behavioural changes can occur because of epilepsy.