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Epileptic Angina.

Sachin Sureshbabu1, Dinesh Nayak2, Sudhir Peter3

  • 1Department of Neurology, St Stephen's Hospital, Tis Hazari, New Delhi 110054, India.

Epilepsy & Behavior Case Reports
|April 11, 2017
PubMed
Summary
This summary is machine-generated.

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Epileptic seizures can rarely cause chest pain, mimicking heart conditions. This study identified an epileptic focus in the left hemisphere responsible for such chest pain episodes.

Area of Science:

  • Neurology
  • Epileptology

Background:

  • Episodic chest pain can be challenging to diagnose, with cardiac causes often investigated first.
  • Unexplained chest pain necessitates exploring less common etiologies, including neurological origins.

Observation:

  • A 14-year-old boy presented with recurrent, short-lived, localized chest pain.
  • Standard cardiac and systemic evaluations, including brain MRI, were unremarkable.
  • Video telemetry was employed to characterize the paroxysmal episodes.

Findings:

  • Interictal EEG revealed left fronto-central epileptiform discharges.
  • Ictal activity localized to the left hemisphere, specifically the centroparietal region.
  • Potential seizure origins include somatosensory areas, supplementary sensorimotor area, posterior insula, and cingulate cortex.
Keywords:
Ictal painInsulaParietalSomatosensory aura

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Implications:

  • Chest pain can be a rare, isolated symptom of focal epilepsy.
  • This case highlights the importance of considering epilepsy in the differential diagnosis of unexplained chest pain.
  • Prompt diagnosis and treatment with antiseizure drugs led to remarkable patient improvement.