Abdominal Epilepsy: A Rare Diagnosis Behind Recurrent Abdominal Pain and Transient Loss of Consciousness

Abdominal epilepsy is a rare and under-recognized form of epilepsy that primarily presents with gastrointestinal manifestations such as recurrent abdominal pain, sometimes accompanied by transient loss of consciousness. Because of its atypical presentation, abdominal epilepsy is frequently misdiagnosed, leading to unnecessary investigations and delayed treatment. We report a 47-year-old woman with a 15-year history of recurrent cramping abdominal pain associated with an intense urge to defecate, collapse, and brief loss of consciousness. Multiple gastrointestinal and cardiac evaluations were unremarkable. Neurological assessment and electroencephalography (EEG) demonstrated focal epileptiform discharges in the left frontal region, consistent with focal seizure activity. Treatment with carbamazepine 200 mg twice daily produced marked symptom improvement within one month, and the patient remained asymptomatic at the 12-month follow-up. This case illustrates the diagnostic challenge abdominal epilepsy poses when symptoms mimic gastrointestinal or syncopal disorders. Early EEG evaluation and neurological referral in patients with recurrent, unexplained abdominal pain and episodic altered consciousness can prevent unnecessary procedures and significantly improve outcomes.