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Chapter 9 - Are Painful Seizures Specific to Insular Epilepsy?

from Section 2 - The Spectrum of Epilepsies Involving the Insula

Published online by Cambridge University Press:  09 June 2022

By
Alexandra Montavont ,
Laure Mazzola ,
Genevieve Demarquay  and
Jean Isnard
Edited by
Dang Nguyen ,
Jean Isnard  and
Philippe Kahane
Dang Nguyen
Affiliation:
Université de Montréal
Jean Isnard
Affiliation:
Claude Bernard University Lyon
Philippe Kahane
Affiliation:
Grenoble-Alpes University Hospital
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Summary

Painful epileptic seizures are scarce and can be a diagnostic challenge, as they may occur as the sole manifestation of seizures. Three categories are distinguished: (1) ictal epileptic headache; (2) ictal abdominal pain; and (3) painful somatosensory seizures, during which patients complain of acute and intense pain affecting part of the body. According to the intracranial EEG recordings, the insulo-opercular cortex and the mesial temporal lobe are implicated in the occurrence of ictal epileptic headache. Such is the case for ictal abdominal pain with the addition of the anterior cingulate gyrus. Stereo-electroencephalography data strongly suggest that painful somatosensory seizures originate in the posterior insula and the secondary sensory area. While ictal epileptic headache and painful abdominal seizures may correspond to an autonomic response resulting from the activation of a central autonomic network, painful somatosensory seizures result from the activation of a central pain network (i.e., the Pain Matrix or Salient Matrix).

Keywords

painful seizuresictal headacheictal abdominal painpainful somatosensory seizureselectrical stimulation
Type
Chapter
Information
Insular Epilepsies , pp. 98 - 109
Publisher: Cambridge University Press
Print publication year: 2022

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