Shihabuddin Bashir S, Harik Sami I
Department of Neurology, University of Arkansas College of Medicine, 4301 W. Markham, Slot 500, Little Rock, Arkansas 72205-7199, United States of America. Tel. +1 (501) 686 5135. Fax. +1 (501) 686 8689. E-mail:
Neurosciences (Riyadh). 2007 Oct;12(4):327-9.
In adults, seizures manifesting with abdominal complaints are usually associated with complex partial or secondary generalized seizures. Also, seizure periodicity is not expected in postmenopausal women. We encountered a 72-year-old woman with episodic nausea and abdominal pain that usually occurred with predictable regularity. When symptoms persisted after extensive gastrointestinal investigations and cholecystectomy, she was referred to us and the diagnosis of simple partial seizures was suspected. Both EEG and brain MRI were normal. The diagnosis was established by video/EEG monitoring, which recorded several typical clinical events associated with right temporal ictal discharges. Because treatment with several antiepileptic medications caused intolerable side effects, the patient is now maintained on a low dose of Lamotrigine, which reduced seizure frequency and severity. This patient demonstrates that abdominal complaints, although rare, may be the sole manifestation of simple partial seizures. Unless considered in the differential diagnosis, the patient may undergo unnecessary and potentially harmful procedures.
在成人中，以腹部不适为表现的癫痫发作通常与复杂部分性发作或继发性全身性发作有关。此外，绝经后女性不应出现癫痫发作的周期性。我们遇到一名72岁女性，她有发作性恶心和腹痛，通常以可预测的规律发作。在进行了广泛的胃肠道检查和胆囊切除术后症状仍持续，她被转诊至我们这里，怀疑为单纯部分性发作。脑电图（EEG）和脑部磁共振成像（MRI）均正常。通过视频/EEG监测确诊，该监测记录了几次与右侧颞叶发作期放电相关的典型临床事件。由于使用几种抗癫痫药物治疗引起无法耐受的副作用，该患者目前维持低剂量拉莫三嗪治疗，这降低了癫痫发作的频率和严重程度。该患者表明，“腹部”不适虽然罕见，但可能是单纯部分性发作的唯一表现。除非在鉴别诊断中考虑到这一点，否则患者可能会接受不必要的、潜在有害的检查。
