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Does epileptic pain really exist?

D E Richardson1

  • 1Department of Neurological Surgery, Tulane University School of Medicine, New Orleans, LA.

Applied Neurophysiology
|January 1, 1987
PubMed
Summary
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Painful seizures typically result from muscle contractions. This study reports the first case of seizures originating within the pain system itself, causing severe chest wall pain.

Area of Science:

  • Neurology
  • Pain Medicine
  • Epileptology

Background:

  • Painful seizures are commonly associated with generalized or focal motor seizures causing secondary pain.
  • Seizures originating from the pain system itself have not been previously documented.

Observation:

  • A patient presented with chronic chest wall pain exhibiting episodic, severe exacerbations.
  • These pain exacerbations were linked to localized focal muscle contractions.
  • Stimulation of the internal capsule could provoke these pain/muscle activity episodes.

Findings:

  • The case demonstrates a novel presentation of seizures originating within the pain system.
  • Intravenous diazepam effectively terminated the pain episodes.
  • Periventricular gray stimulation provided partial pain relief.

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Implications:

  • This case expands the understanding of seizure semiology and potential origins.
  • It suggests that the pain system can be a source of epileptic activity.
  • Further research may explore novel therapeutic targets for refractory pain syndromes.