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October 1959

Convulsive Equivalent States

Author Affiliations

Temple, Texas

AMA Arch Intern Med. 1959;104(4):585-588. doi:10.1001/archinte.1959.00270100071012

Introduction  The number of terms applied to this disorder is exceeded only by the numerous and widespread symptoms and signs that the illness may manifest. In the medical literature, the condition has been described under the following titles: abdominal epilepsy,2 paroxysmal abdominal pain,3,4 hypothalamic and thalamic epilepsy,5 masked epilepsy,6 the periodic syndrome,7 visceral epilepsy,11 diencephalic autonomic epilepsy,8 and diencephalic autonomic discharge.9 The term convulsive equivalent state1 signifies a paroxysmal cerebral dysrhythmia manifested clinically by symptoms in various organ systems. Convulsive movements and loss of consciousness need not be present.1 Of interest to internists are such symptoms as paroxysmal abdominal pain, hypertension, nausea, vomiting, fever, borborygmi and belching, flushing, blanching, cyanosis, urinary incontinence, syncope, and migraine headaches.1,3-5,7,10-19 The paroxysmal nature of the symptoms is the clue to this diagnosis and should lead to a request for an electroencephalogram. Among several patterns that may be noted, the occurrence of 14- and