bubble_chart Overview

Abdominal Apoplexy Syndrome refers to a type of epilepsy characterized by paroxysmal abdominal pain. In 1944, Moore first reported this condition, hence it is also known as Moore Syndrome. Additionally, it has been referred to as visceral epilepsy, diencephalic epilepsy, thalamic and hypothalamic epilepsy, autonomic epilepsy, epileptic variant, convulsive equivalent, epileptic equivalent, non-convulsive epileptic equivalent syndrome, abdominal reflex epilepsy, vermiform epilepsy, autonomic reflex epilepsy, insular epilepsy, and so on.

bubble_chart Etiology

The cause of the disease remains unclear. Some believe it may be due to head trauma, tuberous sclerosis, tumors, or neurovascular edema caused by diphtheria antitoxin injections. Others suggest that some cases are related to factors such as hypoxia during childbirth, premature labor, or severe infectious diseases (e.g., encephalitis). Moore proposed that this episodic intestinal hypermotility is associated with abnormal cortical discharges in the frontal lobe (area 6) and parietal lobe (areas 5 and 3), as well as with the diencephalon. Additionally, a family history of epilepsy or headaches is often present.

bubble_chart Clinical Manifestations

This disease is more common in children, and the onset time can often be traced back to infancy. It is relatively rare in adults, with no significant difference in incidence between males and females. The symptoms manifest as sudden episodes of {|###|}abdominal pain{|###|}, mostly around the umbilicus and upper abdomen, with a few cases radiating to the lower abdomen or lateral sides. The pain is often severe, such as {|###|}colicky pain{|###|} or knife-like, lasting from a few minutes to several hours. During episodes, there is often some degree of consciousness impairment, such as disorientation, perceptual disturbances, or mental confusion, but no complete loss of consciousness. It is frequently accompanied by gastrointestinal symptoms like loss of appetite, {|###|}nausea{|###|}, {|###|}vomiting{|###|}, and {|###|}diarrhea{|###|}. Other autonomic dysfunction symptoms may also occur, such as pale {|###|}complexion{|###|}, skin flushing, sweating, unstable blood pressure, low body temperature or {|###|}fever{|###|}, {|###|}vertigo{|###|}, and {|###|}syncope{|###|}. Most patients feel fatigued, {|###|}drowsy{|###|}, or fall into deep sleep after an episode, waking up feeling well. Episodes may recur multiple times within days. During the intervals between {|###|}abdominal pain{|###|} episodes, other paroxysmal symptoms, such as episodic {|###|}headache{|###|} and various behavioral disturbances, are also common. Various types of epileptic seizures, such as grand mal or psychomotor seizures, may occur. Some patients initially experience paroxysmal {|###|}abdominal pain{|###|} episodes, which later develop into epileptic {|###|}spasm{|###|} seizures.

Abnormal EEG changes are observed in about 67–80% of cases, which may appear during {|###|}abdominal pain{|###|} episodes or during intervals.

bubble_chart Auxiliary Examination

Electroencephalogram (EEG) examination:

Abnormalities include: paroxysmal fast or slow waves, diffuse fast or slow waves, and the appearance of 14 and 6 Hz positive spikes. The EEG shows focal temporal lobe changes, which are typical manifestations of this disease.

bubble_chart Diagnosis

1. There is recurrent paroxysmal abdominal pain, often accompanied by a certain degree of impaired consciousness.

2. No thoracic, abdominal, pelvic, spinal, peripheral nerve, or mental or somatic diseases.

3. Epileptic seizures occur during or before the onset of abdominal pain.

4. There may be a history of central nervous system disease.

5. There are often patients with epilepsy or migraine in the family.

6. Abnormal EEG, often with 14 and 6 Hz positive spikes.

7. Antiepileptic drugs have a good effect on abdominal pain.

bubble_chart Treatment Measures

Antiepileptic drug therapy has a relatively good effect. Commonly used antiepileptic drugs include phenytoin sodium, carbamazepine, phenobarbital, primidone, and sodium valproate, among which phenytoin sodium is the drug of choice.

Chinese medicine Chinese medicinals treatment: For kidney yin deficiency and internal disturbance of liver wind, the treatment principle is liver-calming and wind-extinguishing, often using Antelope Horn and Uncaria Decoction or Gastrodia and Uncaria Drink; for spleen deficiency with dampness exuberance and phlegm-turbidity clouding, the treatment principle is resolving phlegm for resuscitation, commonly using Gallbladder-Warming Decoction, Ningxian Powder, or Zhenxian Tablets.

Acupuncture treatment: Commonly selected acupoints include Fengchi (GB 20), Fengfu (GV 16), Baihui (GV 20), Shangxing (GV 23), Yintang (EX-HN 3), Jiuwei (CV 15), Quchi (LI 11), Neiguan (PC 6), Hegu (LI 4), and Taichong (LR 3).