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Postictal Rash: A Rare Case Reporting to Neurology
Hamza Jamil1, Bridgette King2, Rund Radi Haddadin2
1Neurology, Army Medical College, Rawalpindi, PAK.
Cureus
|October 21, 2024
Summary
Generalized epileptic seizures can cause a rare pinpoint rash. This postictal skin manifestation, appearing after seizures, resolved when the seizures were controlled, aiding diagnosis.
Area of Science:
- Neurology
- Dermatology
Background:
- Epileptic seizures often result in a postictal phase with neurological symptoms like confusion and lethargy.
- Cutaneous manifestations are rare but documented occurrences following generalized epileptic seizures.
Observation:
- A 45-year-old male presented with a pinpoint, non-blanchable petechial rash after experiencing a seizure.
- The rash emerged during transport to the emergency department and resolved within seven days.
- Initial investigations, including imaging and basic laboratory tests, were unremarkable except for elevated postictal markers.
Findings:
- The patient's rash was directly linked to the generalized epileptic seizures.
- No alternative etiology for the petechial rash was identified.
- Resolution of the rash correlated with the control of seizure activity.
Implications:
- Postictal cutaneous manifestations, such as petechiae, can serve as diagnostic indicators for seizures.
- Recognizing these skin changes can prevent unnecessary diagnostic investigations.
- Understanding the pathophysiology, potentially involving hemodynamic shifts and neurogenic inflammation, can enhance epilepsy care management.
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