Topno Noor, Gopasetty Mahesh S, Kudva Annappa, B Lokesh
Department of General Surgery, Kasturba Medical College and Hospital, Manipal-576 119, Karnataka State, India.
Yonsei Med J. 2005 Dec 31;46(6):870-3. doi: 10.3349/ymj.2005.46.6.870.
There are many medical causes of abdominal pain; abdominal epilepsy is one of the rarer causes. It is a form of temporal lobe epilepsy presenting with abdominal aura. Temporal lobe epilepsy is often idiopathic, however it may be associated with mesial temporal lobe sclerosis, dysembryoplastic neuroepithelial tumors and other benign tumors, arterio-venous malformations, gliomas, neuronal migration defects or gliotic damage as a result of encephalitis. When associated with anatomical abnormality, abdominal epilepsy is difficult to control with medication alone. In such cases, appropriate neurosurgery can provide a cure or, at least, make this condition easier to treat with medication. Once all known intra-abdominal causes have been ruled out, many cases of abdominal pain are dubbed as functional. If clinicians are not aware of abdominal epilepsy, this diagnosis is easily missed, resulting in inappropriate treatment. We present a case report of a middle aged woman presenting with abdominal pain and episodes of unconsciousness. On evaluation she was found to have an intra-abdominal foreign body (needle). Nevertheless, the presence of this entity was insufficient to explain her episodes of unconsciousness. On detailed analysis of her medical history and after appropriate investigations, she was diagnosed with temporal lobe epilepsy which was treated with appropriate medications, and which resulted in her pain being relieved.
腹痛有多种医学原因；腹型癫痫是较为罕见的原因之一。它是颞叶癫痫的一种形式，表现为腹部先兆。颞叶癫痫通常是特发性的，然而它可能与内侧颞叶硬化、胚胎发育不良性神经上皮肿瘤及其他良性肿瘤、动静脉畸形、胶质瘤、神经元迁移缺陷或脑炎导致的胶质增生性损伤有关。当与解剖学异常相关时，腹型癫痫仅用药物很难控制。在这种情况下，适当的神经外科手术可以治愈，或者至少使这种疾病更容易通过药物治疗。一旦排除了所有已知的腹腔内病因，许多腹痛病例就被称为功能性腹痛。如果临床医生不了解腹型癫痫，很容易漏诊，导致治疗不当。我们报告一例中年女性患者，表现为腹痛和意识丧失发作。经评估，发现她腹腔内有异物（针）。然而，该异物的存在不足以解释她的意识丧失发作。在详细分析她的病史并进行适当检查后，她被诊断为颞叶癫痫，经适当药物治疗后疼痛缓解。
