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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The electro-encephalogram (EEG) is a useful adjunct when clinical history and physical examination suggest the diagnosis of epilepsy, whether idiopathic, focal or petit mal. It may be helpful in separating the child with simple convulsions due to fever from the child whose epileptic dysrhythmia first finds outward expression while he is feverish. The real nature of disordered behaviour may be demonstrated by the EEG which shows specific evidence of temporal lobe abnormality. In many infective and metabolic disorders of childhood, the EEG has little if any diagnostic specificity, and there is real danger that a variety of entities, such as abdominal pain, aggressive behaviour or minimal brain dysfunction, may be incorrectly attributed to cerebral dysrhythmia on the basis of incidental EEG changes.
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PMID:The electro-encephalogram in childhood. 65 8

Four patients, aged 17 to 47 years, had paroxysmal abdominal pain associated with symptoms suggestive of a CNS disturbance. None had a discernible primary gastrointestinal process, but each had EEG abnormalities and a striking response to anticonvulsant medication. These findings suggest that abdominal epilepsy should be considered in the differential diagnosis of unexplained paroxysmal abdominal pain.
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PMID:Abdominal epilepsy. A cause of abdominal pain in adults. 71 36

Chronic vague abdominal pain is an extremely common complaint in children over 5 years, with a peak incidence in the 8 to 10 year group. In over 90 per cent of the cases no serious underlying organic disease will be discovered. Most disease states can be ruled out by a careful history, a meticulous physical examination, and a few simple laboratory tests such as urinalysis, sedimentation rate, hemoglobin, white blood count determination, and examination of a blood smear. If organic disease is present there are often clues in the history and the examination. The kidney is often the culprit--an intravenous pyelogram should be done if disease is suspected. Barium enema is the next most valuable test. Duodenal ulcers and abdominal epilepsy are rare and are over-diagnosed. If no organic cause is found, the parents must be convinced that the pain is real, and that "functional" does not mean "imaginary." This is best explained by comparing with "headache"--the headache resulting from stress and tension hurts every bit as much as the headache caused by a brain tumor or other intracranial pathology. Having convinced the patient and his parents that no serious disease exists, no further investigation should be carried out unless new signs or symptoms appear. The child must be returned to full activity immediately.
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PMID:Abdominal pain in children. 104 83

From January 1987 to March 1991, electroencephalographic (EEG) analysis and clinical correlates of the 14 and 6 Hz positive spikes were studied retrospectively in 2,026 Chinese patients, ranging in age from 1 to 18 years. All of them were the first-evaluation patients of Pediatric Neurology Clinics, National Taiwan University Hospital, each had had through EEG examinations (including waking and natural sleep records) and detailed medical records. The major findings of the present study are: (1) The overall incidence of the 14 and 6 Hz positive spikes in the series was 2.52% (51/2,026), and that in the age subgroup 1-5 years was significantly lower than those in the subgroups 6-10 years (p less than 0.0001) and 11-15 years (p less than 0.01). (2) 38 out of 51 cases (74.5%) with 14 and 6 Hz positive spikes presented normal EEG background activity. (3) 7 out of 51 cases (13.7%) had coincided negative spikes in frontal areas, and 12 out of 51 cases (23.5%) were associated with other focal or generalized paroxysmal discharges. (4) From the analysis of the clinical manifestations in the 51 cases with the 14 and 6 Hz positive spikes, the episodic attacks of headache, abdominal pain or other autonomic symptoms were most common (49%, 25/51 cases). Of the 25 cases, 19 cases (37.2%, 19/51 cases) were finally diagnosed as autonomic seizure or abdominal epilepsy and 3 cases were diagnosed as migraine. 3 of 10 cases with convulsive seizure or complex partial seizure were associated with autonomic symptom. (5) The etiology in 36 out of 51 cases (70.6%) remained unknown.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Analysis and clinical correlates of the 14 and 6 Hz positive electroencephalographic spikes in Chinese children. 177 55

We report a 14-year-old boy with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS) who presented repeated episodes of abdominal pain and vomiting since the age of 8 years. In addition, he developed strokelike episodes with myoclonic seizures and transient hemiplegia on three occasions. At the age of 14-1/12-years, he also developed epilepsia partialis continua persisting for 10 days, which was associated with myoclonic seizures synchronized with spike discharges at the right central area. Laboratory examination disclosed increased levels of lactate and pyruvate in serum and CSF and low density areas in the bilateral temporal regions on CT scan. Muscle biopsy showed scattered ragged-red fibers. The enzyme activities (pyruvate dehydrogenase complex, pyruvate carboxylase, phosphoenol pyruvate carboxykinase, and cytochrome c oxidase) and the rates of decarboxylation of [3-14C]pyruvate in cultured skin fibroblasts were within normal ranges.
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PMID:[A case with MELAS associated with epilepsia partialis continua]. 189 96

We studied the clinical efficacy of allopurinol as add-on therapy in 31 patients with intractable epilepsy. When administered for a short time, allopurinol was effective in 17 patients (55%); 8 were seizure-free, 8 had 75% decrease in seizure frequency, and 1 had greater than 50% decrease. Allopurinol was most effective in patients with localization-related epilepsy, especially in secondarily generalized tonic-clonic seizures. Allopurinol was not as effective in patients with Lennox syndrome or West syndrome, or in severe myoclonic epilepsy in infants. When allopurinol was administered greater than 1 year, its initial effectiveness continued in 8 of 14 patients who exhibited initial improvement. In 2 of the remaining 6 patients, the initial improvement disappeared during the course of treatment but control was regained by increasing the dosage of allopurinol. Mild side effects were observed in 4 patients (13%): drowsiness in 3 and abdominal pain in 1. Allopurinol may be a useful antiepileptic drug (AED), and a double-blind placebo-controlled trial should be performed.
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PMID:Clinical effects of allopurinol on intractable epilepsy. 190 Jul 91

Part I. The EEG recordings of 434 patients were activated by graded sleep deprivation. In clinically manifest epilepsies with a predominantly negative EEG tracing at rest the incidence of epileptic manifestations increased after sleep deprivation from 18.03% to 59.01%, in clinically suspect epilepsies from 6.4% to 39.0%. In other paroxysmal affections such as febrile convulsions, syncopes and collapses, paroxysms of abdominal pain or headaches, affective paroxysms and nocturnal terrors, the tracing activation by sleep deprivation mostly facilitated differential diagnosis between those affections and epilepsy. In organic cerebral affections with or without epileptic seizures activation by sleep deprivation led to an increase in the occurrence of epileptic manifestations from 11.4% to 50.0% of the recordings. The authors conclude that graded sleep deprivation is a very useful activation method for the diagnosis of epilepsy. Part II. The authors studied the occurrence of generalized 2-5 Hz high-amplitude slow wave episodes in 244 patients before and after sleep deprivation. They found such episodes in the resting recordings of 37 patients and in the post-deprivation recordings of 85 patients. The described episodes were mostly observed during sleepiness and superficial sleep. They were significantly more frequent in children and adolescents than in adults. The occurrence of slow wave episodes was ascertained in epileptic as well as non-epileptic affections such as affective attacks in children, night terrors, paroxysms of abdominal pain or headaches, febrile convulsions and organic brain affections without epileptic seizures. The authors conclude that the above episodes are a non-specific manifestation of increased susceptibility to paroxysmal synchronization of EEG rhythms. Their occurrence in young children can, however, be considered normal.
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PMID:Activation of EEG recordings by graded sleep deprivation. 242 21

We compared the clinical and biochemical profiles of 11 patients with idiopathic flushing (IF) with those of eight patients with carcinoid syndrome (CS). Patients with IF were more often women, had a longer duration of symptoms, and were younger. Palpitations, syncope, and hypotension occurred only in patients with IF, while wheezing and abdominal pain occurred only with CS; diarrhea occurred in both types of patients. Elevated blood serotonin levels were present primarily in CS. Increased levels of urine 5-hydroxyindoleacetic acid was specific for CS but unsufficiently sensitive to detect all cases. Abnormalities of gut and vasoactive peptides failed to distinguish the two conditions. Flushing in carcinoid patients responds uniformly to octreotide (Sandostatin), but only one third of the patients with IF are relieved of the symptom. Patients with IF have features that distinguish them from individuals with flushing from other causes, such as CS, postmenopausal state, chlorpropamide-alcohol flush, panic attacks, medullary thyroid carcinoma, and autonomic epilepsy. Familiarity with the clinical and biochemical features of IF should facilitate evaluation and identification of these patients.
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PMID:Distinguishing features of idiopathic flushing and carcinoid syndrome. 246 88

Much difficulties are often encountered in finding the underlying cause of recurrent abdominal pain. Clinical features may vary from one patient to the other and occasionally from one episode to the next even in the same child. The recent development of fibre optic endoscopy may well prove to have a useful diagnostic technique, particularly in those children in whom other investigations are inconclusive. The result of endoscopic examinations in children with recurrent abdominal pain comprising of 62 children aged between 3-13 years were as follows: erosion in 7 children, oesophagitis in 4 children, duodenitis in 3 children, spasm of the pylorus in 2 children, and normal findings were found in 30 children. Of the 30 patients with "normal" endoscopic findings, 7 had psychosomatic problems, 4 had allergy, 4 had urinary tract infection, 2 showed giardiasis, one had epilepsy, 1 was treated as pulmonary tuberculosis, where as in 11 patients organic as well as nonorganic abnormalities could not be found. There seem to be of no significant correlation between the endoscopic and upper gastrointestinal series findings. Endoscopy seem to be of a safe and reliable tool in the diagnosis of a number of organic intestinal lesions otherwise not detected by ordinary investigations.
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PMID:Endoscopic examinations in children with recurrent abdominal pain. 248 37

A 10-year-old child presented with recurrent abdominal pain. Abdominal epilepsy was suspected as conventional criteria for the diagnosis were met, including an apparent therapeutic response to anticonvulsant medication. Seven months later the patient developed recurrent abdominal pain, a gait disorder, and atrophy of the right thigh and calf. Magnetic resonance imaging of the spine revealed a thoracic syringomyelia. Anticonvulsant medications were discontinued and a syringoperitoneal shunt was placed with resolution of symptoms. This appears to be a previously undescribed presentation for syringomyelia and emphasizes the importance of considering alternative central nervous system disorders before the diagnosis of abdominal epilepsy is made.
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PMID:Spinal cord tumor-associated syrinx mimicking abdominal epilepsy: a rare cause of childhood abdominal pain. 262 31


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