Journal of Pediatric Epilepsy 2017; 06(04): 186-189
DOI: 10.1055/s-0037-1608868
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Excessive Cry in a 5-Month-Old Infant Possibly due to Abdominal Epilepsy

Soumya Roy
1   Department of Paediatric Medicine, Institute of Child Health, Kolkata, West Bengal, India
,
Sumit Datta Majumdar
1   Department of Paediatric Medicine, Institute of Child Health, Kolkata, West Bengal, India
,
Subroto Chakrabartty
1   Department of Paediatric Medicine, Institute of Child Health, Kolkata, West Bengal, India
,
Swati Chakravarti
1   Department of Paediatric Medicine, Institute of Child Health, Kolkata, West Bengal, India
› Author Affiliations
Further Information

Publication History

28 April 2017

24 October 2017

Publication Date:
06 December 2017 (online)

Abstract

Excessive and unexplained cry is a common problem with infants. Most of the causes are benign or easily treatable, with exception of a few. However, we encountered a 5-month-old, otherwise healthy male infant, who used to cry inconsolably every day on the afternoon for about 3 hours and then used to fall asleep. This had been going on for the last 6 weeks. After waking up, infant seemed perfectly normal. History, physical examination, and routine investigations failed to diagnose the cause. An electroencephalogram showed epileptic abnormalities. The “crying episodes” disappeared after starting phenobarbitone. Although two of the four criteria for diagnosis of abdominal epilepsy (AE) are impossible to be met in an infant of this age (because he cannot speak out his ailments whether he is having abdominal pain, headache, dizziness, etc.); still we believe that this was a case of AE. Various case reports have stated that “sustained response to anticonvulsants has been accepted as one of the criteria for the diagnosis of AE.” We suggest AE to be kept in mind even when dealing with an infant of unresolved excessive crying.

 
  • References

  • 1 Akhnikh S, Engelberts AC, van Sleuwen BE, L'Hoir MP, Benninga MA. The excessively crying infant: etiology and treatment. Pediatr Ann 2014; 43 (04) e69-e75
  • 2 Cerminara C, El Malhany N, Roberto D, Curatolo P. Focal epilepsy with ictal abdominal pain: a case report. Ital J Pediatr 2013; 39: 76
  • 3 Zinkin NT, Peppercorn MA. Abdominal epilepsy. Best Pract Res Clin Gastroenterol 2005; 19 (02) 263-274
  • 4 Arumugam J, Sivandam S, Vijayalakshmi A. The evaluation and management of an incessantly crying infant. Sri Lanka J Child Health 2012; 41 (04) 192-198
  • 5 Critch J. Infantile colic: Is there a role for dietary interventions?. Paediatr Child Health 2011; 16 (01) 47-49
  • 6 Douglas P, Hill P. Managing infants who cry excessively in the first few months of life. BMJ 2011; 343: d7772
  • 7 Mirzoev A, Bercovici E, Stewart LS, Cortez MA, Snead III OC, Desrocher M. Circadian profiles of focal epileptic seizures: a need for reappraisal. Seizure- European. J Epilepsy 2012; 21 (06) 412-416
  • 8 Durazzo TS, Spencer SS, Duckrow RB, Novotny EJ, Spencer DD, Zaveri HP. Temporal distributions of seizure occurrence from various epileptogenic regions. Neurology 2008; 70 (15) 1265-1271
  • 9 Karafin M, St Louis EK, Zimmerman MB, Sparks JD, Granner MA. Bimodal ultradian seizure periodicity in human mesial temporal lobe epilepsy. Seizure 2010; 19 (06) 347-351
  • 10 Pavlova MK, Shea SA, Bromfield EB. Day/night patterns of focal seizures. Epilepsy Behav 2004; 5 (01) 44-49
  • 11 Quigg M, Clayburn H, Straume M, Menaker M, Bertram III EH. Effects of circadian regulation and rest-activity state on spontaneous seizures in a rat model of limbic epilepsy. Epilepsia 2000; 41 (05) 502-509
  • 12 Pavlova MK, Shea SA, Scheer FA, Bromfield EB. Is there a circadian variation of epileptiform abnormalities in idiopathic generalized epilepsy?. Epilepsy Behav 2009; 16 (03) 461-467
  • 13 Stewart LS, Leung LS, Persinger MA. Diurnal variation in pilocarpine-induced generalized tonic-clonic seizure activity. Epilepsy Res 2001; 44 (2-3): 207-212
  • 14 Stewart LS, Nylen KJ, Persinger MA, Cortez MA, Gibson KM, Snead III OC. Circadian distribution of generalized tonic-clonic seizures associated with murine succinic semialdehyde dehydrogenase deficiency, a disorder of GABA metabolism. Epilepsy Behav 2008; 13 (02) 290-294
  • 15 Badawy RA, Macdonell RA, Jackson GD, Berkovic SF. Why do seizures in generalized epilepsy often occur in the morning?. Neurology 2009; 73 (03) 218-222
  • 16 Zdraveska N, Kostovski A. Epilepsy presenting only with severe abdominal pain. J Pediatr Neurosci 2010; 5 (02) 169-170
  • 17 Blumberg J, Fernández IS, Vendrame M. , et al. Dacrystic seizures: demographic, semiologic, and etiologic insights from a multicenter study in long-term video-EEG monitoring units. Epilepsia 2012; 53 (10) 1810-1819
  • 18 Van Buren JM. The abdominal aura. A study of abdominal sensations occurring in epilepsy and produced by depth stimulation. Electroencephalogr Clin Neurophysiol 1963; 15: 1-19
  • 19 Yingkun F. Abdominal epilepsy. Chin Med J (Engl) 1980; 93 (03) 135-148
  • 20 Paton DM, Webster DR. Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines). Clin Pharmacokinet 1985; 10 (06) 477-497
  • 21 TRICLOFOS - National Library of Medicine HSDB Database, 2002 . (online). Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+3276 . Accessed October 14, 2017