How Abdominal Epilepsy Is Diagnosed

Abdominal epilepsy¹ is a very rare, chronic form of epilepsy that can cause recurrent seizures in the stomach and intestines. Although abdominal epilepsy is fairly common in children, it is extremely rare in adults. If you have stomach pains, especially as an adult, there are many other possibilities to rule out before considering abdominal epilepsy. 

What are abdominal convulsions?

Abdominal epilepsy is characterized by abdominal convulsions, which are seizures in the digestive system. These seizures affect a number of bodily functions, leading to the symptoms brought on by this condition. 

Abdominal convulsions can cause:

• Confusion after a seizure

• Abdominal cramping

• Vomiting

• Unresponsiveness during a seizure

• Convulsions, often seen as a typical shaking fit

• Fatigue after the seizure

• Sharp, uncomfortable abdominal pain

These associated symptoms can be varied, but the main symptom of abdominal epilepsy is paroxysmal episodes of abdominal pain². This simply means that the episodes (in this case, seizures) occur repeatedly. 

What causes abdominal epilepsy?

There has only been limited research on abdominal epilepsy because the condition is so rare. In addition, it can be difficult to differentiate abdominal epilepsy from other kinds of abdominal pain that are common in children.

However, in children with epilepsy who also have unexplained recurrent abdominal pain, abdominal epilepsy could be the cause. 

The current thinking around the cause of abdominal epilepsy focuses on the brain. Although it may seem strange to study the brain when the chief complaint is stomach pain, this approach can help distinguish abdominal epilepsy from other kinds of stomach pain. 

Due to the rarity of the condition and its being most common in children, very little is known about the actual causes of abdominal epilepsy. Some sources contend that there are no known causes, while others maintain theories about causes without solid evidence³. 

Why does epilepsy cause abdominal pain?

The prevailing theory is that abdominal seizures are caused during focal seizures, of the simple or complex type⁴. These are seizures that occur in one part of the brain and are characterized by how they affect a person. Simple focal seizures can cause twitching or changes in physical sensations, while complex seizures cause confusion or a dazed feeling. 

Although we don’t know what else occurs to bring on the abdominal pain during these seizures, it could be caused by the twitching or spasming of abdominal muscles as a response to a simple focal seizure.

Abdominal epilepsy usually lasts a few minutes and occurs at least once daily⁵, sometimes several times per day. The small section of the brain that goes haywire triggers the muscles in the stomach to contract and loosen and can cause pain and vomiting. 

Diagnosis of abdominal epilepsy

Diagnosing abdominal epilepsy is very difficult because so little is known about the condition. This lack of understanding often causes distress for people who haven’t been diagnosed, particularly children and their guardians.

Diagnosis of abdominal epilepsy is made more difficult because we cannot simply ‘take a look’ inside the stomach without some kind of procedure. However, many non-invasive procedures such as ultrasounds, endoscopy, colonoscopy, and gastroscopy are available. Laparoscopy⁶ is another tool that can help diagnose abdominal epilepsy and rule out other conditions. 

Laparoscopy is also known as keyhole surgery. This procedure uses a small surgical camera known as a laparoscope, which is inserted through a small incision in the abdomen. Gas is then pumped into the stomach to inflate the intestines so the surgeon can have a look around, utilizing the live images from the laparoscope.

This procedure is quite versatile and is used to diagnose disorders in the female reproductive system, the digestive system, or the urinary system. It is a painless procedure carried out under a general anesthetic. It is also an incredibly safe procedure.

A laparoscopy won’t definitively show that you have abdominal epilepsy, as the condition is thought to be caused by changes in the brain. However, it does help to rule out other potential conditions, which helps your physician diagnose abdominal epilepsy with more confidence.

Does abdominal epilepsy show on EEG?

Another tool used to confirm abdominal epilepsy, and other forms of seizures, is an electroencephalogram, or an EEG⁷. This recording analyses your brain waves and helps to characterize and map the activity of your brain. 

An EEG can be difficult to use in the diagnosis of seizures. This is because an EEG can only record brain activity when the patient is connected to the device. So if you don’t have a seizure while being assessed with the EEG, the doctors won’t be able to diagnose you with epilepsy. 

However, doctors can sometimes use triggers to create seizures while a patient is attached to an EEG to determine if a patient has epilepsy. A doctor might diagnose the patient with abdominal epilepsy if there is a history of abdominal pain, fatigue after seizure, confusion or loss of consciousness after seizure, and an abnormal EEG.

Treatment

The treatment for abdominal epilepsy will target the brain and not the abdomen. This is because, as mentioned earlier, the main cause of the associated pain is the focal seizure occurring in the brain. 

The treatment for abdominal epilepsy involves using anti-epileptic medications known as AEDs. Many different types of AED are available and have various levels of effectiveness. Your doctor may have you try different medications to ensure you are prescribed the one that works best for you. 

The lowdown

Abdominal epilepsy is a form of epilepsy characterized primarily by the presence of abdominal pain. Because this condition is so rare, we don’t know much about it. It’s thought to be caused by focal seizures in the brain, which can lead to symptoms such as vomiting and abdominal pain.

The diagnosis of abdominal epilepsy is quite involved, but the condition is readily treatable with anti-epileptic medications.