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[Ictus emeticus. Vomiting as epileptic manifestation]
1Statens senter for epilepsi, Sandvika.
Summary
Ictus emeticus, characterized by nausea and vomiting during epileptic seizures, is a rare but recognized phenomenon. Epileptic disturbances in the insula and mesial temporal lobe structures are likely responsible for this complex autonomic symptom.
Area of Science:
- Neurology
- Neuroscience
- Gastroenterology
Background:
- Epileptic seizures often manifest with autonomic and visceral symptoms.
- Recurrent vomiting as a primary ictal event (ictus emeticus) is less commonly recognized.
Observation:
- This study describes three patients presenting with ictus emeticus, where nausea and vomiting were the predominant ictal symptoms.
- Vomiting involves complex gastrointestinal and vagal nerve pathways, controlled by the brainstem's vomiting center.
Findings:
- Experimental and clinical evidence suggests a link between epileptic disturbances in the insula and mesial temporal structures and ictus emeticus.
- These cerebral structures influence the brainstem's autonomic vomiting center.
Implications:
- Understanding the neurobiological basis of ictus emeticus can improve diagnosis and management of specific epilepsy types.
- Highlights the intricate connection between cerebral activity and complex autonomic functions like vomiting.