American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is characterized by a rising epigastric sensation as the most common aura?

1. Frontal lobe epilepsy

2. Temporal lobe epilepsy

3. Occipital lobe epilepsy

4. Myoclonic epilepsy

The correct answer is: Temporal lobe epilepsy

The condition characterized by a rising epigastric sensation as the most common aura is temporal lobe epilepsy. Temporal lobe epilepsy is a focal epilepsy that often manifests with various types of auras, and a rising sensation in the epigastric region is a classic symptom reported by many patients experiencing seizures originating in the temporal lobe. Patients may describe this aura as a feeling of butterflies or a sensation of rising discomfort in the abdomen, which can precede the actual seizure. This type of aura is thought to arise due to abnormal electrical activity in the limbic structures of the temporal lobe, which are integral to processing emotions and autonomic functions, including gastrointestinal sensations. Other types of epilepsy, such as frontal lobe and occipital lobe epilepsy, tend to involve different auras or symptoms that are typically not associated with this specific epigastric sensation. Myoclonic epilepsy is characterized by sudden muscle jerks rather than aura sensations. Therefore, temporal lobe epilepsy distinctly stands out for its association with the rising epigastric aura.