Painful focal sensory seizure arising from the primary somatosensory cortex.

A 31-year-old, right-handed woman had frequent focal painful seizures involving the right hand without any movement. EEG demonstrated an ictal activity arising from the left centroparietal region. No cerebral structural abnormality was seen on MRI. Ictal single photon emission CT showed markedly increased activity in the left perirolandic cortex, which remained active following the ictal symptoms when the EEG seizure pattern had completely disappeared. It is concluded that the painful seizures in the present patient originated from the primary somatosensory cortex. The prolonged increase of regional blood flow in the perirolandic area may reflect the possibility of persistent subclinical epileptogenicity.