Mucous Diarrhea and Abnormal Colonic Dilatation as Seizure Presentation in a Patient With Post‐Stroke Epilepsy

ABSTRACT A 66‐year‐old man with a history of left parietal lobe hemorrhage presented with impaired consciousness, right‐ward conjugate eye deviation, and trembling movements of right fingers. While initial motor signs resolved with antiseizure medication, impaired consciousness persisted and was subsequently accompanied by colonic dilatation and mucous diarrhea for several days. Five days after the first episode resolved, a second similar episode occurred. During the second episode, scalp electroencephalogram showed an evolving seizure pattern, and I‐N‐isopropyl‐iodoamphetamine single photon emission computed tomography revealed hyperperfusion in the left parietal, insular, and temporal cortices. While ictal colonic dilatation has been reported, mucous diarrhea as a seizure symptom is unprecedented. The reproducibility of abdominal signs suggests mucous diarrhea and colonic dilatation as ictal symptoms of post‐stroke epilepsy.