Epilepsy and the gut: Perpetrator or victim?  

作　　者：Mohammed Al-Beltagi Nermin Kamal Saeed 

机构地区：[1]Department of Pediatrics,Faculty of Medicine,Tanta University,Tanta 31527,Algharbia,Egypt [2]Department of Pediatrics,University Medical Center,King Abdulla Medica City,Arabian Gulf University,Manama 26671,Bahrain [3]Department of Pediatrics,University Medical Center,King Abdulla Medical City,Dr.Sulaiman Al Habib Medical Group,Manama 26671,Bahrain [4]Medical Microbiology Section,Department of Pathology,Salmaniya Medical Complex,Ministry of Health,Kingdom of Bahrain,Manama 26612,Bahrain [5]Department of Microbiology,Irish Royal College of Surgeon,Busaiteen 15503,Muharraq,Bahrain

出　　处：《World Journal of Gastrointestinal Pathophysiology》2022年第5期143-156,共14页世界胃肠病理生理学杂志（英文版）（电子版）

摘　　要：The brain and the gut are linked together with a complex,bi-path link known as the gut-brain axis through the central and enteric nervous systems.So,the brain directly affects and controls the gut through various neurocrine and endocrine processes,and the gut impacts the brain via different mechanisms.Epilepsy is a central nervous system(CNS)disorder with abnormal brain activity,causing repeated seizures due to a transient excessive or synchronous alteration in the brain’s electrical activity.Due to the strong relationship between the enteric and the CNS,gastrointestinal dysfunction may increase the risk of epilepsy.Meanwhile,about 2.5%of patients with epilepsy were misdiagnosed as having gastrointestinal disorders,especially in children below the age of one year.Gut dysbiosis also has a significant role in epileptogenesis.Epilepsy,in turn,affects the gastrointestinal tract in different forms,such as abdominal aura,epilepsy with abdominal pain,and the adverse effects of medications on the gut and the gut microbiota.Epilepsy with abdominal pain,a type of temporal lobe epilepsy,is an uncommon cause of abdominal pain.Epilepsy also can present with postictal states with gastrointestinal manifestations such as postictal hypersalivation,hyperphagia,or compulsive water drinking.At the same time,antiseizure medications have many gastrointestinal side effects.On the other hand,some antiseizure medications may improve some gastrointestinal diseases.Many gut manipulations were used successfully to manage epilepsy.Prebiotics,probiotics,synbiotics,postbiotics,a ketogenic diet,fecal microbiota transplantation,and vagus nerve stimulation were used successfully to treat some patients with epilepsy.Other manipulations,such as omental transposition,still need more studies.This narrative review will discuss the different ways the gut and epilepsy affect each other.

关 键 词：EPILEPSY Epilepsy with abdominal pain GUT Gastrointestinal diseases Gut-brain-microbiota axis Abdominal aura Ketogenic diet Abdominal migraine 

分 类 号：R742.1[医药卫生—神经病学与精神病学]