Epilepsy Foundation

My son has been gagging and vomiting, complaining of tummy aches for several months. his primary care dr has no idea what is causing it and his nuero dr has said it is most likely medication toxicity... the culprit being trileptol his dose being raised around the time all this started. since the decrease he did ok for a few days now the vomiting is back the sad thing is the trileptol has really helped seizure wise. does anybody have any ideas about what this could be or info about med toxicity?

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If the trileptal is helping with seizures, I would really try and find others causes of the N&V.

We deal with this a lot.

Is the N&V all of the time, does it have triggers ... does it seem cyclic?

My daughter had N&V triggered by travel (even only after 15 or so minutes) She eventually started having episodes of N&V that settled into a pretty predictable cycle of every 4 to 6 weeks. Prior to that N&V was a bit more sporatic.

In my daughters case, she has underlying autonomic dysfunction and N&V are common problems. Her episodes (that we call autonomic episodes) though we think are either cyclic vomiting syndrome (whhc is a migraine variant) and/or possibly seizure related or a little of both.

Here is  some info on the migraine variants in children:

http://emedicine.medscape.com/article/1178141-clinical

Abdominal migraine

  • The child may complain of episodic pain, nausea, and vomiting. The headache may be minimal or absent. An aura may precede the pain but is not frequent. Symptoms are relieved by sleep and antiemetic and/or antimigraine therapies.
  • Cyclic vomiting of childhood, which can be associated with a mitochondrial cytopathy, may be a severe variant of abdominal migraine.
  • Diagnosis is difficult to make during the first episode.

Autonomic simple focal seizure (AKA aura)

http://www.epilepsyontario.org/client/EO/EOWeb.nsf/web/Simple+Parti...

Simple partial seizures take different forms in different people. They are further classified according to their symptoms:

Autonomic Seizures - These seizures are accompanied by autonomic symptoms or signs, such as abdominal discomfort or nausea which may rise into the throat (epigastric rising), stomach pain, the rumbling sounds of gas moving in the intestines (borborygmi), belching, flatulence and vomiting. This has sometimes been referred to as abdominal epilepsy. Other symptoms may include pallor, flushing, sweating, hair standing on end (piloerection), dilation of the pupils, alterations in heart rate and respiration, and urination. A few people may experience sexual arousal, penile erection, and orgasm.

J

 that was really helpful thank you so much :) this gives me alot to think about and talk to with my sons nuero doc next week at his appt

My daughter also throws up with seizures alot of the time....That is how I know she is having them..We have complex partial seizures....

this is more common then i realized... my son ALSO has complex partials and before he was diagnosed with epilepsy the drs were trying to say he had some weird gastro disorder, gagging and vomiting has always gone along with this even though now it seems it is worsening

Iggy's mom,

 

My son has been dealing with this also since shortly after his diagnosis. At first we thought it was his Depakote levels, but after cutting his dose in half, it was still happening. For my son it would be like a cycle - he would be fine for a few weeks then daily upset stomach aches/upset stomach/and vomit once or twice a day during the cycle. Then he would be fine for a few more weeks. His Depakote levels and liver enzimes always were normal when we had them read. It came and went fast, but he had a horrible summer because of this. It became really draining. Then I tried the pedi again, and he diagnosed him as having GERD. He has been doing well since stating prevacid daily. It has helped heal what is going on inside. He has the occasional upset stomach (including this morning) but at least he has been in school much more often. I'm still not sure what to think of it though.

 

I would like to know what you find out at the neurologist appt about this. I too wondered if these are seizures. Are there are any tests to diagnose Autonomic Seizures?   My son also has complex partials.

 

jjbeck, thank you...you had great info! 

   

An EEG during the episode is probably the only way to know for sure.

Sometimes though, autonomic seizures do not show up on an EEG ... though I am not sure how often that happens. I know one mom had a son who had these symptoms but they only showed up on EEG when they did the subdural eeg.

The best thing to do is to find an epi that really understands the differnet seizure types.



A.C. said:


I would like to know what you find out at the neurologist appt about this. I too wondered if these are seizures. Are there are any tests to diagnose Autonomic Seizures?   My son also has complex partials.

 

jjbeck, thank you...you had great info! 

   

My son has been dealing with vomiting for years, only at night and shortly after going to sleep since an infant.  Severe abdominal pains at all times of day for years.  At 4 1/2 he was diagnoses with abdominal migraines and migraine headaches due to our heavy family history of migraines.  The abdominal migraines never sat right with me.  At 5, my mom and I told the neuro we thought my son was having seizures (staring spells).  He said it was impossible.  Fast forward a few months we switched health care carriers-they immediately did EEG-Yes he had seizures-generalized absence seizures.  Pretty sig.  few failed trials of meds and a 24 hour EEG with video in the hospital 7 months after int. diagnosis.  Seizures more than we thought.  Interesting thing happened on video and showed up on EEG.  My son had severe abdominal pain, doubled over, and at the same moment it registered on the EEG.  The neuro was able to see that the abdominal pain was related to seizures.  

I am still new to all this. And it is all confusing.  It is nice to be able to share.

Gaela

I believe too (as nuero) that tummy/constipation related. Ours are in the occipital lobe and her type is assoc with vomitting and nausea.. I also notice if she becomes not regular..I have a potential problem. Good luck..

My son has stomach pains which we believe are autonomic seizures. We have never been able to capture them on EEG, but from what I understand, this kind of seizure often does not show up on regular eeg. He has also never had a full blown episode of them while on eeg, just a brief very minor version of it, which is why I think they didn't show up.

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