Siegel A M, Williamson P D, Roberts D W, Thadani V M, Darcey T M
Dartmouth-Hitchcock Medical Center, Section of Neurology, Lebanon, New Hampshire 03756, USA.
Epilepsia. 1999 Jul;40(7):845-55. doi: 10.1111/j.1528-1157.1999.tb00790.x.
Ictal pain is a rare symptom of seizures. Epileptic pain may be experienced unilaterally (lateral/ peripheral), cephalically, or in the abdomen. Painful seizures have been associated with seizure origin in both the parietal and the temporal lobes. We report on the different types of epileptic pain and discuss its etiology and possible localizing value.
We reviewed the records of patients referred to our epilepsy program over the last 6 years. Eight (1.4%) of 573 patients had pain as an early prominent symptom of their seizures.
Pain was predominantly unilateral in three patients, cephalic in two, and abdominal in three patients. Seizure onset was in or involving the parietal lobe in all patients, and when the painful symptoms were lateralized, they were contralateral to the side of seizure origin. Parietal lobe seizure origin was determined by both intracranial EEG recording and neuroimaging [magnetic resonance imaging (MRI), ictal single photon emission computed tomography (SPECT)] in five patients, and by both scalp EEG and neuroimaging in three patients.
We conclude that ictal pain is a rare symptom of parietal lobe seizure origin with lateralizing potential.
发作期疼痛是癫痫发作的一种罕见症状。癫痫性疼痛可能单侧出现（外侧/外周）、头部出现或腹部出现。疼痛性发作与顶叶和颞叶的发作起源有关。我们报告不同类型的癫痫性疼痛，并讨论其病因及可能的定位价值。
我们回顾了过去6年转诊至我们癫痫治疗项目的患者记录。573例患者中有8例（1.4%）以疼痛作为发作的早期突出症状。
3例患者疼痛主要为单侧，2例为头部疼痛，3例为腹部疼痛。所有患者发作起始于顶叶或累及顶叶，当疼痛症状呈单侧化时，与发作起源侧对侧。5例患者通过颅内脑电图记录和神经影像学检查[磁共振成像（MRI）、发作期单光子发射计算机断层扫描（SPECT）]确定顶叶发作起源，3例患者通过头皮脑电图和神经影像学检查确定。
我们得出结论，发作期疼痛是顶叶发作起源的一种罕见症状，具有定位潜力。
