Priyangaa Sathasivam* and Dr. Naveen Kumar M.


Central pain of epileptic etiology is very rare. The frequency of painful sensations in epileptic seizures varies between 0.3 and 2.8%. We report a patient with short-lasting painful attacks in the right arm. Changes in the electroencephalography (EEG) and the effective treatment with anticonvulsants in contrast to the therapeutic failure of analgesics, lead to the diagnosis of partial epilepsy with painful seizures. Magnetic resonance imaging (MRI) of the brain was normal, whereas a postcentral parietal site of seizure origin involving the secondary somatosensory area was suggested by electroencephalographic findings. The literature is reviewed for cases with pain as the sole or predominant symptom of epileptic seizures. Jacksonian seizures were analyzed in 42 patients with regard to anatomical and temporal sequences. The origin of sensory Jacksonian seizures, in contrast to motor Jacksonian seizures, often began at peripheral sites with little cortical representation. The progression of seizure activity across the cerebral cortex followed a course that was neither rectilinear, radiate, nor random; it appeared to proceed in an organized manner to involve functionally coherent units. The patterns analyzed conformed more closely to cortical somatosensory maps reported for the chimpanzee than the sensory sequences presently available for the cortex of man. Complete diagnostic studies are indicated in patients presenting with sensory Jacksonian seizures because of the frequency of related focal pathology.

Keywords: Jacksonian, Seizure, March, Epilepsy.

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