Patient's question:
The child has already started elementary school. Recently, they have been complaining of abdominal pain, and it was initially thought that it was due to catching a cold. However, it has persisted for some time, and sometimes they also experience vomiting. Is it possible that the child's abdominal pain and vomiting could be epilepsy?Doctor's answer:
The forms of epilepsy seizures, except for petit mal and bilateral severe myoclonus, can occur in any type of epilepsy. Focal meningeoencephalitis of the frontal pole often causes tonic-clonic seizures without warning. Lesions in the frontal central region typically cause contralateral motor or sensory focal seizures. Temporal lobe lesions lead to psychomotor seizures, while occipital lobe lesions are often associated with visual auras. In most patients, the seizure type remains relatively stable, though a few may experience changes. Early and mid-stage epilepsy may spontaneously remit in about 25% of patients within 2 years or slightly longer, but late-stage epilepsy tends to worsen, potentially evolving from focal seizures to generalized seizures. Severe cases may also manifest as memory impairment, personality disorders, or intellectual disability.Recommendations: The diagnosis of epilepsy primarily relies on electroencephalography (EEG): EEG is a crucial auxiliary diagnostic tool for epilepsy. With the use of multiple provocation methods, special electrodes, long-term or video-EEG, the positive rate exceeds 80%. It can detect features such as spike-wave complexes or burst rhythms, which are significant for localizing focal epilepsy. However, 1–3% of normal individuals may exhibit epileptic discharges, and a considerable number of patients in the interictal period have normal EEG results. Therefore, EEG alone should not be used to diagnose or rule out epilepsy.