Pain and epilepsy. A clinical, neuroanatomical and pathophysiological review

Besides postictal headaches, epileptic seizures are infrequently associated with pain experiences. Nevertheless, seizure-associated pain is an important clinical symptom to recognize, diagnose and to differentiate from non-epileptic disorders. Seizure-associated pain may shed light on the anatomical and pathophysiological foundation of pain in general. According to its localization seizure-related pain is classified as unilateral somatosensory, abdominal and cephalic epileptic pain and according to its temporal relationship as ictal, peri-ictal, and interictal pain. Different aspects of pain phenomena in the context of epileptic seizures will be addressed by following these systematic classifications. In relation to seizures with unilateral somatosensory manifestation the functional anatomical context is described while differential diagnostic aspects in association with abdominal epilepsies are emphasized and terminological points as well as genetic epidemiological interrelationships between epilepsy and migraine are highlighted.