Repeated abdominal pain and vomiting could be a sign of "Abdominal Epilepsy"
1/n
Abdominal pain & vomiting are common symptoms of many gastrointestinal disorders. However, in some patients, no obvious cause can be found despite extensive investigations.
Case report
#MedTwitter
1/n
Abdominal pain & vomiting are common symptoms of many gastrointestinal disorders. However, in some patients, no obvious cause can be found despite extensive investigations.
Case report
#MedTwitter
2/n
22-year old woman presented with repeated episodes of epigastric #abdominal #pain associated with #vomiting of three months duration. Symptoms occurred almost on daily basis, more in evenings, post which she felt tired and lethargic. She was evaluated by gastroenterologist.
22-year old woman presented with repeated episodes of epigastric #abdominal #pain associated with #vomiting of three months duration. Symptoms occurred almost on daily basis, more in evenings, post which she felt tired and lethargic. She was evaluated by gastroenterologist.
3/n
Extensive investigations- upper GI endoscopy, CT and ultrasound of abdomen, LFT, serum amylase, etc were normal. Symptomatic treatment also did not help. At this point she was referred for my opinion.
#gastroenterology #internalmedicine
Extensive investigations- upper GI endoscopy, CT and ultrasound of abdomen, LFT, serum amylase, etc were normal. Symptomatic treatment also did not help. At this point she was referred for my opinion.
#gastroenterology #internalmedicine
4/n
Reviewing her history, I suspected a diagnosis of abdominal #Epilepsy. EEG showed epileptiform discharges arising from both temporal lobes. MRI brain was normal. The diagnosis of abdominal epilepsy was confirmed. I started her on oxcarbazepine 300 mg twice daily.
Reviewing her history, I suspected a diagnosis of abdominal #Epilepsy. EEG showed epileptiform discharges arising from both temporal lobes. MRI brain was normal. The diagnosis of abdominal epilepsy was confirmed. I started her on oxcarbazepine 300 mg twice daily.
5/n (final)
Reviewed the patient today after 4 weeks: she had not had a single episode of abdominal pain or vomiting.
Take home message: Consider a diagnosis of abdominal epilepsy in patients with repeated abdominal pain & vomiting, when all GI-related causes have been excluded.
Reviewed the patient today after 4 weeks: she had not had a single episode of abdominal pain or vomiting.
Take home message: Consider a diagnosis of abdominal epilepsy in patients with repeated abdominal pain & vomiting, when all GI-related causes have been excluded.
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