Epilepsy and the gut: Perpetrator or victim?

Table 1 Differences between epilepsy with abdominal pain and abdominal migraine

Parameter	Epilepsy with abdominal pain	Abdominal migraine
Age	Mainly pediatric age (4-9 yr), scarce in adults	It starts in childhood (3-10 yr with a peak at 7), though it may occur in adults
Sex	More in males during childhood, more in females in adulthood	More in females
Prevalence	Very rare	More common affect 2% to 4% of children
Etiology	Focal partial temporal lobe epilepsy due to idiopathic or secondary causes	Food allergy, Mitochondrial DNA mutation (cytopathy), Corticotropin-releasing factors abnormalities, Endogenous prostaglandin release
Family history		Strong family history of migraine
Duration of episodes	Usually 10-30 min, 4–5 times/month	Usually, more than an hour (3-4 h), at least twice/6 mo
Aura	May present	May present
Headache if present	Short duration	Long duration
Consciousness	May be altered	Not affected
Postictal tiredness or confusion	May present	absent
EEG	Abnormal epileptogenic electrical activity of focal temporal epilepsy	Usually, normal
Postictal serum Prolactin	Usually, high	Usually normal, it may be high, especially in females
Prevention	Prevention and treatment of the cause in secondary cases and sleep hygiene in idiopathic cases	Good sleep hygiene, hydration, stress reduction, and avoiding dietary triggers
Prophylaxis therapy	Antiseizure medications	Amyltryptine, propranolol, cryoheptadine, pizotifen

EEG: Electroencephalogram.