Abdominal epilepsy in an adolescent with bilateral perisylvian polymicrogyria.
OBJECTIVE
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.


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.
García-Herrero
D
D
Servicio de Neurofisiología Clínica, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Fernández-Torre
J L
JL
Barrasa
J
J
Calleja
J
J
Pascual
J
J
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000002:abnormalities*; D004569:Electroencephalography / Q000706:statistics & numerical data; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008881:Migraine Disorders / Q000175:diagnosis / Q000209:etiology; D009421:Nervous System Malformations / Q000150:complications / Q000175:diagnosis; D014635:Valproic Acid / Q000627:therapeutic use
D014635:Valproic Acid