PAROXYSMAL PAIN AS SOLE MANIFESTATION OF SEIZURES

A developmentally normal 4-year-old white female who presented with pa in in the right hand as the only manifestation of epilepsy is reported . Two years later, she developed complex partial seizures following ri ght-hand pain. Computed tomography and magnetic resonance imaging were unremarkable. Prolonged ambulatory electroencephalography (EEG) as we ll as video-EEGs with ictal pain episodes failed to reveal abnormaliti es. Only a full night video-EEG performed after antiepileptic drug wit hdrawal demonstrated 2 right-hand pain episodes followed by a complex partial seizure with ictal epileptiform activity on the scalp EEG in t he left parasagittal area, rapidly generalized and interictal discharg es in the C3-P3 area. This patient had a very unusual presentation of epilepsy.