title: Mesial temporal lobe epilepsy presenting with rising epigastric sensation as the only clinical symptom: a case report.
abstract: Mesial temporal lobe epilepsy is generally manifested as central nervous system disorder, emotional disturbances, and visceral discomfort. We present the case of an elderly male patient with mesial temporal lobe epilepsy presenting with rising epigastric sensation as the only manifestation. A 60-year-old male patient who had been regularly suffering from episodic epigastric sensations three to seven times every day was admitted to our hospital. 'Rising air' initiated from epigastria, ascending to his chest, and terminated in the throat. Brain MRI showed sclerosis of the right hippocampus and enlargement of the right temporal horn. Video electroencephalography showed that the seizure was associated with a high-amplitude spike and slow wave, originating from the right anterior temporal region and extending to the leads in the right hemisphere. Extensive gastrointestinal and cardiothoracic investigations showed no abnormality, and so an underlying seizure disorder was suspected. The patient was prescribed a low dose of carbamazepine of 200 mg daily and was discharged the next day. A repeat video electroencephalography confirmed the satisfactory efficacy of the treatment. During the follow-up period of 22 months, there was no reappearance of epilepsy. Primary physicians, especially gastroenterologists, should be acquainted with the manifestations of simple partial seizures to avoid any dispensable medical examinations, even maltreatments.
authors.affiliation: Departments of aEmergency bNeurosurgery cNeurology, First Norman Bethune Hospital of Jilin University dCollege of Basic Medicine, Jilin University, Changchun, Jilin, China.
authors.forename: Lichao
authors.initials: L
authors.lastname: Sun
authors.forename: Jinran
authors.initials: J
authors.lastname: Li
authors.forename: Hongmei
authors.initials: H
authors.lastname: Song
authors.forename: Weihong
authors.initials: W
authors.lastname: Lin
mesh_terms: D001921:Brain / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology*; D005500:Follow-Up Studies; D041981:Gastrointestinal Tract / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome; D014741:Video Recording