Karın ağrısı ve şuur bozukluğu : abdominal epilepsili olgu
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Tarih
2015
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info:eu-repo/semantics/openAccess
Özet
Abdominal epilepsi, karın ağrısı bulantı ve kusma gibi gastrointestinal semptomların, letarji ve konvülziyon gibi nörolojik bulguların sık görüldüğü, tekrarlayıcı, az görülen bir durumdur. Genellikle çocukluk yaş grubunda görülmekle birlikte erişkinlerde de görülebilmektedir. Karın ağrısı yapan nedenlerin tanısal olarak ekarte edilmesinin ardından elektroensefalografi (EEG) ile değerlendirilerek tanı konmaktadır. Antiepileptiklerle semptomların düzelmesi tanıda önemlidir. On yedi yaşında kadın hasta aniden gelişen şuur bozukluğu nedeniyle acil servise getirildi. Hastanın genel durumu orta, şuuru konfüze, glaskow koma skalası (GKS): 11 (E: 2 M: 5 V: 4), tansiyonu 100/60 mmHg, nabzı 100/dk, solunumu 20/dk, ateşi 37.2 derece ve diğer fizik muayene bulguları doğaldı. Koma değerlendirmesine alınan hastanın ilk kan şekeri değeri 85 mg/dl ve serum amilaz, lipaz dahil acil kan parametreleri normaldi. Hastanın takipleri sırasında ikinci saatte şuuru tamamen açıldı. Karın ağrısı ayırıcı tanısı için istenilen incelemeleri de normaldi. Çekilen beyin tomografisinde anormallik saptanmazken EEG’sinde orta derecede aktif epileptiform anormalite ile uyumlu bulgular gösteren dalgalar tespit edildi. Levetirasetam tedavisi başlanan hastanın bir yıllık poliklinik kontrollerinde problem olmadı. Acil hekimleri karın ağrısı ve şuur bozukluğu olan hastalarda ayırıcı tanıda nadir görülen bir durum olan abdominal epilepsiyi düşünmelidir. Ayırıcı tanı amaçlı yapılan ilk incelemelerin ardından EEG ile hastalar değerlendirilmelidir.
Abdominal epilepsy is a recurrent and rare condition characterized by gastrointestinal symptoms such as abdominal pain, nausea, vomiting and neurological findings such as lethargy and convulsion. Although usually seen in childhood, it can also be seen in adults. After ruling out more common causes of abdominal pain, it is diagnosed with electroencephalography (EEG). The improvement of symptoms with antiepileptics is important in diagnosis. A 17-year-old woman was admitted to the emergency department with sudden loss of consciousness. On admission, general condition of the patient was moderate. The patient had confusion, and her other vital signs were as follows: Glasgow Coma Scale (GCS) at 11 (E: 2M: 5V: 4); arterial blood pressure, 100/60 mmHg; heart rate, 100 beats/min; respiration rate, 20 breaths/min and temperature, 37.2°C. Other physical examination findings were normal. First serum glucose level was 85 mg/dL. Serum amylase, lipase and other laboratory test results were within normal limits. After two hours of monitoring, her consciousness was completely opened. For differential diagnosis of abdominal pain, control results were normal. There was not any abnormal findings in computed tomography (CT) scans of brain. In EEG recordings, moderately active epileptiform abnormalities were detected. Levetirasetam medication was initiated. There were no problems observed during the one-year treatment period. Abdominal epilepsy is a rare condition that should be considered in patients presented with abdominal pain and confusion. After the initial tests performed for differential diagnosis of abdominal pain, patients should be evaluated with EEG.
Abdominal epilepsy is a recurrent and rare condition characterized by gastrointestinal symptoms such as abdominal pain, nausea, vomiting and neurological findings such as lethargy and convulsion. Although usually seen in childhood, it can also be seen in adults. After ruling out more common causes of abdominal pain, it is diagnosed with electroencephalography (EEG). The improvement of symptoms with antiepileptics is important in diagnosis. A 17-year-old woman was admitted to the emergency department with sudden loss of consciousness. On admission, general condition of the patient was moderate. The patient had confusion, and her other vital signs were as follows: Glasgow Coma Scale (GCS) at 11 (E: 2M: 5V: 4); arterial blood pressure, 100/60 mmHg; heart rate, 100 beats/min; respiration rate, 20 breaths/min and temperature, 37.2°C. Other physical examination findings were normal. First serum glucose level was 85 mg/dL. Serum amylase, lipase and other laboratory test results were within normal limits. After two hours of monitoring, her consciousness was completely opened. For differential diagnosis of abdominal pain, control results were normal. There was not any abnormal findings in computed tomography (CT) scans of brain. In EEG recordings, moderately active epileptiform abnormalities were detected. Levetirasetam medication was initiated. There were no problems observed during the one-year treatment period. Abdominal epilepsy is a rare condition that should be considered in patients presented with abdominal pain and confusion. After the initial tests performed for differential diagnosis of abdominal pain, patients should be evaluated with EEG.
Açıklama
Anahtar Kelimeler
Klinik Nöroloji, Nörolojik Bilimler
Kaynak
Epilepsi
WoS Q Değeri
Scopus Q Değeri
Cilt
21
Sayı
1
