Casciato Sara, Morano Alessandra, Fattouch Jinane, Fanella Martina, Albini Mariarita, Giallonardo Anna Teresa, Di Bonaventura Carlo
Epilepsy Unit, Department of Neurology and Psychiatry, 'Sapienza' University, Rome, Italy.
Pract Neurol. 2017 Oct;17(5):400-402. doi: 10.1136/practneurol-2017-001623. Epub 2017 Jun 9.
We report an adult with acute unilateral pain as isolated manifestation of acute symptomatic focal non-convulsive status epilepticus. Pain is rarely a manifestation of epileptic seizures. Traditionally, painful seizures have been thought to originate in either the parietal or temporal lobes, but their localising value is debatable. Recent functional neuroimaging studies and electrophysiological findings obtained by using intracerebral recordings have shown the involvement of the insular cortex along with several other brain structures in the processing of painful inputs, comprising a more widespread anatomo-functional network. Despite their rarity as a distinct clinical entity, especially in adults, painful somatosensory seizures can be disabling and misdiagnosis or delayed diagnosis is common; it is therefore essential to consider epilepsy as a possible cause of paroxysmal pain to ensure proper assessment and appropriate treatment.
我们报告了一名成年人，其急性单侧疼痛是急性症状性局灶性非惊厥性癫痫持续状态的孤立表现。疼痛很少是癫痫发作的表现。传统上，疼痛性癫痫发作被认为起源于顶叶或颞叶，但其定位价值存在争议。最近的功能神经影像学研究以及通过脑内记录获得的电生理结果表明，岛叶皮层以及其他几个脑结构参与了疼痛输入的处理，构成了一个更广泛的解剖-功能网络。尽管疼痛性体感癫痫作为一种独特的临床实体很少见，尤其是在成年人中，但疼痛性体感癫痫可能会使人致残，误诊或延迟诊断很常见；因此，必须将癫痫视为阵发性疼痛的可能原因，以确保进行适当的评估和治疗。
