Beware of Sudden Abdominal Pain – It Could Be Epilepsy

A typical case

T.T., a 31-year-old from Phu Tho, suffered sudden abdominal pain, vomiting, and brief loss of awareness. The episodes became more frequent, sometimes more than 10 times a day, especially after sleepless nights. Initial diagnoses focused on gastrointestinal disorders, but tests revealed no clear cause. Further neurological evaluation confirmed abdominal epilepsy.
After two weeks on anti-epileptic medication, the patient’s condition stabilized, and the painful episodes stopped.

Key characteristics

According to Dr. Ta Van Hai (Phu Tho General Hospital), abdominal epilepsy does not usually cause full-body seizures but shows up as gastrointestinal symptoms: abdominal pain, vomiting, diarrhea, fatigue, or fainting. These symptoms are often misdiagnosed as digestive disorders, leading to delayed treatment.
Dr. Le Dinh Luong (Thu Cuc International General Hospital) explained that epileptic seizures occur when neurons in the brain’s cortex fire abnormally. When this abnormal activity affects the autonomic nerves linked to digestion, patients experience abdominal pain instead of convulsions.

Mechanism and risks

The exact mechanism remains unclear, but studies suggest that seizures may originate in a small area of the temporal lobe, disrupting autonomic nerve function.
Without proper diagnosis and treatment, patients risk complications such as repeated vomiting, dehydration, electrolyte imbalance, loss of consciousness, and long-term effects on both physical and mental health.

Often confused with cyclic vomiting syndrome

Abdominal epilepsy can be mistaken for cyclic vomiting syndrome (CVS), a condition usually seen in children aged 3–7. CVS involves predictable cycles of severe vomiting, often in the morning, lasting hours or days, with associated diarrhea, headaches, and malnutrition.
Treatment differs: abdominal epilepsy responds to anti-epileptic drugs, while CVS is managed mainly with symptom-control medications (anti-nausea drugs, pain relief, nutritional support).

Recommendation

Sudden, intense abdominal pain with vomiting and altered consciousness should not be ignored. Patients should seek neurological evaluation, including EEG testing, to rule out epilepsy. Early diagnosis ensures effective treatment and prevents dangerous complications.