Question
A primary school child is experiencing persistent abdominal pain accompanied by vomiting, and the parents are inquiring whether this could be an epileptic seizure.
Answer
Epileptic seizures can manifest in various forms, including minor seizures and bilateral severe muscle spasms. Beyond these typical attack forms, other types of epilepsy can also cause abdominal pain and vomiting. For instance, frontal lobe meningeal epilepsy may lead to grand mal seizures without any prodromes; frontal-parietal central zone lesions may cause contralateral limb motor or sensory focal seizures; temporal lobe lesions may result in psychomotor seizures; and occipital lobe lesions may be accompanied by visual prodromes. Most epilepsy patients have relatively fixed seizure types, but for a few, the types may change. Early and middle-stage epilepsy patients may sometimes resolve spontaneously within 2 years or more, but late-stage epilepsy patients may show a worsening trend, with seizure types evolving from focal to generalized, potentially leading to complications such as memory loss, personality disorders, and intellectual disability. Diagnosing epilepsy usually relies on electroencephalograms (EEGs), which are important auxiliary tools for diagnosis. Through specific provocation methods, special electrodes, and long-duration or video EEG recordings, higher diagnostic positive rates can be achieved. However, 1% to 3% of normal individuals may also exhibit EEG patterns similar to epilepsy, and during the interictal period of epilepsy seizures, many patients’ EEGs may appear normal. Therefore, relying solely on EEGs cannot definitively confirm or rule out a diagnosis of epilepsy.