Abdominal aura (from Latin '','' "belly," and , "wind, odor, or gleam of light"), also known as visceral aura and epigastric aura, is a type of

somatosensory The somatosensory system, or somatic sensory system is a subset of the sensory nervous system. The main functions of the somatosensory system are the perception of external stimuli, the perception of internal stimuli, and the regulation of bod ...

aura that typically manifests as abdominal discomfort in the form of nausea, malaise, hunger, or pain. Abdominal aura is typically associated with

epilepsy Epilepsy is a group of Non-communicable disease, non-communicable Neurological disorder, neurological disorders characterized by a tendency for recurrent, unprovoked Seizure, seizures. A seizure is a sudden burst of abnormal electrical activit ...

, especially

temporal lobe epilepsy In the field of neurology, temporal lobe epilepsy is an enduring brain disorder that causes unprovoked seizures from the temporal lobe. Temporal lobe epilepsy is the most common type of focal onset epilepsy among adults. Seizure symptoms and b ...

, and it can also be used in the context of migraine. The term is used to distinguish it from other types of somatosensory aura, notably visual disturbances and

paraesthesia Paresthesia is a sensation of the skin that may feel like numbness (''hypoesthesia''), tingling, pricking, chilling, or burning. It can be temporary or chronic and has many possible underlying causes. Paresthesia is usually painless and can oc ...

. The abdominal aura can be classified as a

somatic Somatic may refer to: * Somatic (biology), referring to the cells of the body in contrast to the germ line cells ** Somatic cell, a non-gametic cell in a multicellular organism * Somatic nervous system, the portion of the vertebrate nervous syst ...

hallucination A hallucination is a perception in the absence of an external stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming ( REM sleep), which does not involve wakefulness; pse ...

. Pathophysiologically, the abdominal aura is associated with aberrant neuronal discharges in sensory cortical areas representing the abdominal viscera.

Presentation

A variety of sensations and associated symptoms can be attributed to abdominal aura: * abdominal discomfort, including a feeling of

bloating Abdominal bloating (or simply bloating) is a short-term disease that affects the gastrointestinal tract. Bloating is generally characterized by an excess buildup of gas, air or fluids in the stomach. A person may have feelings of tightness, pressu ...

or rumbling * abdominal pain, which is often midline and cramping * a 'rising' sensation in the abdomen *

nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. It can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat. Over 30 d ...

vomiting Vomiting (also known as emesis, puking and throwing up) is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteritis, pre ...

* flatulence * hunger * malaise * lethargy * vegetative symptoms such as blushing and sweating The symptoms of abdominal aura generally coincide with or precede the associated migraine or seizure, and depending on the etiology, they may last seconds to hours.

Epilepsy

In epilepsy, aura refers to a type of

focal seizure Focal seizures are seizures that originate within brain networks limited to one hemisphere of the brain. In most cases, each seizure type has a consistent site of onset and characteristic patterns of spread, although some individuals experience mo ...

, in which seizure activity is limited to a portion of the brain and the person remains conscious and may experience a wide variety of sensory effects. This type of focal seizure can often, but does not always, precede or evolve into another type of seizure. Abdominal aura is a common type of epileptic aura, and it is very common in temporal lobe epilepsy compared to extratemporal focal epilepsies. In one study, more than half of patients with temporal lobe epilepsy experienced abdominal aura, and most of those cases of abdominal aura evolved into a generalized motor seizure. In addition to the abdominal pain and nausea/vomiting, other symptoms of seizures can sometimes be seen in abdominal epilepsy and may be helpful in diagnosis, including a duration of seconds to minutes, confusion or unresponsiveness during episodes, lethargy or sleep after episodes, and progression from abdominal aura into another type of seizure. If the abdominal aura does not precede or evolve into another type of seizure, it can be very difficult to diagnose. The most conclusive way to diagnose abdominal epilepsy is by correlating the abdominal symptoms with epileptic activity on an

electroencephalogram Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The bio signals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the neoc ...

(EEG). The presence of episodic abdominal complains in a person with known epilepsy does not necessarily indicate that they are having epileptic abdominal aura, as abdominal discomfort and nausea are very common symptoms in people with and without epilepsy. Treatment of abdominal epilepsy generally consists of anticonvulsants to prevent the seizures.

Migraine

Migraine aura typically precedes the onset of headache, evolves slowly, and most commonly consists of visual, sensory, and/or speech and language changes. Migraine aura can also occur in isolation without the headache. Nausea, vomiting, and abdominal discomfort are common symptoms of migraine, and while they are not classically considered aura symptoms for the purposes of diagnosing migraine with aura, the abdominal symptoms may still precede and predict the onset of migraine headache.

Related disorders

Abdominal aura is also seen in some disorders that are closely related to migraine, including cyclical vomiting syndrome and abdominal migraine. Cyclical vomiting syndrome is a condition associated with recurrent episodic attacks of vomiting with periods of normalcy in between. It most commonly presents in childhood, and its symptoms overlap strongly with the gastrointestinal symptoms of migraine. While poorly understood, it is also believed to be related to migraine in its etiology. There are mitochondrial DNA changes that are common among patients with cyclical vomiting syndrome and patients with migraine, and a family history of migraine is common among people who are diagnosed with cyclical vomiting syndrome. Abdominal migraine is an episodic disorder associated with recurring episodes of severe abdominal pain in the ''absence'' of headache. In addition to abdominal pain, symptoms often include anorexia, nausea, vomiting, and pallor. Episodes typically last 2-72 hours, and patients are completely symptom-free in between episodes. It most commonly presents during childhood, and most children who experience abdominal migraine will go on to develop migraine headaches later in life.

Reference

{{Reflist somatosensory system Medical signs Symptoms and signs: Digestive system and abdomen Epilepsy Migraine

Presentation

Epilepsy

Migraine

Related disorders

See also

Reference