A Rare but Treatable Cause of Recurrent Chest Pain - Ictal Chest Pain

Overview

Journal BMC Neurol

Publisher Biomed Central

Specialty Neurology

Date 2020 Jan 1

PMID 31888520

Citations 1

Authors

Ching Soong Khoo

Dongah Lee

Kang Min Park

Byung In Lee

Sung Eun Kim

Affiliations

Soon will be listed here.

Abstract

Background: Chest pain as the primary manifestation of epilepsy is extremely rare and has only been reported once to date.

Case Presentation: We herein describe a 47-year-old woman with recurrent chest pain for 3 years. The cause of her chest pain remained elusive despite extensive investigations including comprehensive cardiac work-up. She was referred to the neurology clinic for one episode of confusion. Video-electroencephalographic monitoring detected unequivocal ictal changes during her habitual chest pain events. She has remained chest pain (seizure) free with a single antiseizure drug.

Conclusions: This case underlines the importance of epilepsy as a rare yet treatable cause of recurrent chest pain. Further studies are required to determine the pathophysiology of ictal chest pain.

Citing Articles

Ictal chest discomfort in a patient with temporal lobe seizures and amygdala enlargement.

Ohseto H, Soga T, Kakisaka Y, Jin K, Ukishiro K, Konomatsu K Epilepsy Behav Rep. 2023; 21:100578.

PMID: 36606273 PMC: 9807991. DOI: 10.1016/j.ebr.2022.100578.

References

Obaid S, Zerouali Y, Nguyen D . Insular Epilepsy: Semiology and Noninvasive Investigations. J Clin Neurophysiol. 2017; 34(4):315-323. DOI: 10.1097/WNP.0000000000000396. View

Dainese F, Mai R, Francione S, Mainardi F, Zanchin G, Paladin F . Ictal headache: headache as first ictal symptom in focal epilepsy. Epilepsy Behav. 2011; 22(4):790-2. DOI: 10.1016/j.yebeh.2011.10.007. View

Bernasconi A, Andermann F, Bernasconi N, Reutens D, Dubeau F . Lateralizing value of peri-ictal headache: A study of 100 patients with partial epilepsy. Neurology. 2001; 56(1):130-2. DOI: 10.1212/wnl.56.1.130. View

Franzon R, Lopes C, Schmutzler K, Morais M, Guerreiro M . Recurrent abdominal pain: when should an epileptic seizure be suspected?. Arq Neuropsiquiatr. 2002; 60(3-A):628-30. DOI: 10.1590/s0004-282x2002000400021. View

Luders H, Lesser R, Dinner D, Hahn J, Salanga V, MORRIS H . The second sensory area in humans: evoked potential and electrical stimulation studies. Ann Neurol. 1985; 17(2):177-84. DOI: 10.1002/ana.410170212. View

Pazarci N, Bebek N, Baykan B, Gurses C, Gokyigit A . Reappraisal of epileptic pain as a rare symptom of seizures. Epilepsy Behav. 2016; 55:101-7. DOI: 10.1016/j.yebeh.2015.12.015. View

Tuxhorn I . Somatosensory auras in focal epilepsy: a clinical, video EEG and MRI study. Seizure. 2005; 14(4):262-8. DOI: 10.1016/j.seizure.2005.02.005. View

Cerminara C, El Malhany N, Roberto D, Curatolo P . Focal epilepsy with ictal abdominal pain: a case report. Ital J Pediatr. 2013; 39:76. PMC: 3892002. DOI: 10.1186/1824-7288-39-76. View

Mauguiere F, Courjon J . Somatosensory epilepsy. A review of 127 cases. Brain. 1978; 101(2):307-32. DOI: 10.1093/brain/101.2.307. View

10.

Sureshbabu S, Nayak D, Peter S, Sobhana C, Mittal G . Epileptic Angina. Epilepsy Behav Case Rep. 2017; 7:49-53. PMC: 5377006. DOI: 10.1016/j.ebcr.2017.02.001. View

11.

Siegel A, Williamson P, Roberts D, Thadani V, Darcey T . Localized pain associated with seizures originating in the parietal lobe. Epilepsia. 1999; 40(7):845-55. DOI: 10.1111/j.1528-1157.1999.tb00790.x. View

12.

Rosenberg D, Mauguiere F, Catenoix H, Faillenot I, Magnin M . Reciprocal thalamocortical connectivity of the medial pulvinar: a depth stimulation and evoked potential study in human brain. Cereb Cortex. 2008; 19(6):1462-73. DOI: 10.1093/cercor/bhn185. View

13.

Trevathan E, Cascino G . Partial epilepsy presenting as focal paroxysmal pain. Neurology. 1988; 38(2):329-30. DOI: 10.1212/wnl.38.2.329. View

14.

Young G, Blume W . Painful epileptic seizures. Brain. 1983; 106 (Pt 3):537-54. DOI: 10.1093/brain/106.3.537. View

15.

Parisi P, Striano P, Verrotti A, Villa M, Belcastro V . What have we learned about ictal epileptic headache? A review of well-documented cases. Seizure. 2013; 22(4):253-8. DOI: 10.1016/j.seizure.2013.01.013. View

16.

Alkawadri R, So N, Van Ness P, Alexopoulos A . Cingulate epilepsy: report of 3 electroclinical subtypes with surgical outcomes. JAMA Neurol. 2013; 70(8):995-1002. PMC: 5123738. DOI: 10.1001/jamaneurol.2013.2940. View

17.

Asadi-Pooya A, Asadollahi M, Sperling M . Ictal pain: occurrence, clinical features, and underlying etiologies. Epilepsy Behav. 2016; 61:59-62. DOI: 10.1016/j.yebeh.2016.05.006. View