Acute, Localized Paroxysmal Pain: An Uncommon Ictal Manifestation

Pain is a recognized, but rare manifestation of epileptic seizures. Pain associated with seizures can be severe and disabling. Ictal pain is usually associated with paresthesia, thermal sensations, or somatognostic disturbance. If localized, paroxysmal pain is the sole manifestation, seizure may be often overlooked as a cause for pain, leading to unnecessary investigations and erroneous treatment, resulting in the prolongation of suffering. We hereby report the case of a 6-year-old boy, whose initial manifestation was multiple episodes of localized, intense, disabling paroxysms of pain over multiple body sites. He was diagnosed to have focal unaware seizures, and was started on antiepileptic drugs, leading to complete resolution of symptoms.