Abdominal epilepsy, also known as autonomic epilepsy, abdominal epilepsy is a rare condition most frequently found in children that consist of gastrointestinal (GI) disturbances caused by epileptiform seizure activity.  Abdominal epilepsy has been described as a type of temporal lobe epilepsy.

The most common symptom of abdominal epilepsy is abdominal pain followed by uncontrollable vomiting, usually preceded by lethargy. Symptoms also include generalized tonic-clonic seizures followed by sleep, confusion, and unresponsiveness.

It is unknown as to what causes abdominal epilepsy. While a causal relationship between seizure activity and the GI symptoms has not been proven, the GI symptoms cannot be explained by other pathophysiological mechanisms, and are seen to improve upon anticonvulsant treatment. Because the condition is so rare, no high-quality studies exist. There have been too few reported cases to identify risk factors, genetic factors, or other potential causes.

How Is Abdominal Epilepsy Diagnosed?

Diagnosing abdominal epilepsy can involve a chicken-or-the-egg debate. Seizures in epilepsy are sometimes preceded by patterns of symptoms. These patterns of symptoms are called auras. Just before a seizure, some people with epilepsy might smell something that’s not there. Others might see flashing lights.

Auras with abdominal symptoms are common in epilepsy. You can call it a gut feeling. Nausea, pain, flatulence, or hunger can herald a seizure. But are the abdominal symptoms ever evidence of seizures in their own right?

A complete family history as to past seizure experienced by the patient or by members of his/her family may be revealing and helpful in establishing a diagnosis of abdominal epilepsy. A study of 46 children 19 revealed a past history of seizures state and 25 had experienced febrile seizures in infancy.

Some experts think the diagnosis of abdominal epilepsy should be made when abdominal symptoms are the main manifestation of seizure activity.  They propose these criteria for the diagnosis of abdominal epilepsy:

  • periodic abdominal symptoms that can’t be explained after extensive medical testing, including blood tests, imaging scans, and endoscopy
  • symptoms that suggest a central nervous system problem (for example, confusion or lethargy)
  • an abnormal electroencephalogram EEG
  • sustained absence of abdominal symptoms while taking an epilepsy medication