Abdominal Epilepsy in an Adolescent with Bilateral Perisylvian Polymicrogyria

• Published in: Epilepsia (Copenhagen) Vol. 39; no. 12; pp. 1370 - 1374
• Main Authors: García‐Herrero, D., Fernhndez‐Torre, J. L., Barrasa, J., Calleja, J., Pascual, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-12-1998; Blackwell
• Subjects: Abdominal epilepsy; Abdominal Pain - diagnosis; Abdominal Pain - etiology; Adolescent; Adult; Bilateral sylvian cortical malformation; Biological and medical sciences; Cerebral Cortex - abnormalities; Electroencephalography - statistics & numerical data; Epilepsy, Temporal Lobe - diagnosis; Epilepsy, Temporal Lobe - drug therapy; Epilepsy, Temporal Lobe - etiology; Female; Functional Laterality; Humans; Magnetic Resonance Imaging; Malformations of the nervous system; Medical sciences; Migraine Disorders - diagnosis; Migraine Disorders - etiology; Nervous System Malformations - complications; Nervous System Malformations - diagnosis; Neurology; Polymicrogyria; Simple partial seizures; Valproic Acid - therapeutic use; Human; Nervous system diseases; Bilateral; Electroencephalography; Congenital disease; Cerebral disorder; Abdominal epilepsy; Case study; Electrodiagnosis; Partial; Malformation; Etiology; Central nervous system disease; Adolescent; Female; Diagnosis
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1111/j.1528-1157.1998.tb01340.x

Purpose: We report a patient with recurrent episodes of severe periumbilical pain accompanied by headache, pallor, dizziness, and visual hallucinations who was subsequently diagnosed as having abdominal epilepsy and a bilateral sylvian cortical malformation.
Methods and Results: During an EEG examination, the patient had a simple partial seizure, manifested as intense abdominal pain. The ictal EEG showed a focal electrographic seizure arising from the left frontotemporal region. Computed tomography scan was normal; however, magnetic resonance imaging (MRI) revealed asymmetric lesions involving both sylvian fissures compatible with polymicrogyria. Onset of treatment with sodium valproate was followed by a significant reduction of seizures.
Conclusions: Abdominal epilepsy should be suspected in adolescents or adults with paroxysmal episodes of abdominal pain associated with migraine‐like symptoms. EEG and MRI investigations are indicated. A developmental brain disorder should be considered as a possible etiology.