Purpose: To investigate the probable ictal origin of unexplained episodic chest pain and if possible to lateralize and localize the epileptic focus.
Methods: A 14 year old boy presented with episodic short lasting localized chest pain. His cardiac and other systemic work-up were normal. MRI brain did not reveal any structural pathology. Video telemetry was done for characterization of the paroxysms.
Results: Interictal record showed left fronto-central epileptiform discharges. A left hemispheric, predominantly centroparietal ictal rhythm was identified. The possible localizations of this unusual semiology are somatosensory areas I and II, supplementary sensorimotor area, posterior insula and cingulate cortex. Patient responded remarkably to antiseizure drugs.
Conclusion: Pain is a rare manifestation of epilepsy observed in less than 1% of patients. When present, it is usually accompanied by other focal features. This rare occurrence of epileptic seizures masquerading as angina is a novel observation.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5377006 | PMC |
| http://dx.doi.org/10.1016/j.ebcr.2017.02.001 | DOI Listing |
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