Ictal analgesia in temporal lobe epilepsy - The mechanism of seizure-related burns

A. Szűcs, András Horváth, G. Rásonyi, Dániel Fabó, Géza Szabó, Anna Sákovics, A. Kamondi

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Abstract

Seizure-related injuries have major impact in the excess mortality and morbidity of epilepsy patients. Experimental data suggest that analgesia may develop during seizures contributing to the severity of seizure-related accidents, especially burns. We aimed to identify those seizure-types that may lead to burn-injuries by seizure-related analgesia. In our tertiary epilepsy centre, we asked 100 epilepsy patients having a history of seizure-related injury, to complete our burn-and-pain questionnaire. Fifty-one patients completed the survey; their epileptology data were collected and those with a seizure-related burn were interviewed. Forty-two out of the 51 patients (82%) had partial epilepsy and 9 (18%) had idiopathic generalised epilepsy. Twenty-six persons (51%) reported decreased pain perception during or after seizures in general. Twelve patients (23%) had suffered one or more seizure-related burn. Five of them fell onto a hot surface or fire accidentally, during generalized tonic-clonic seizures. Seven out of the 12 burnt patients (58%) grasped a hot object or reached into boiling fluid during complex partial seizures; without experiencing-, or reacting in response to pain. These patients had temporal lobe epilepsy, 5 of them had left temporal seizure onset. Our hypothesis based on the circumstantial analysis of our patients' burn-injuries; is that temporal lobe seizures may cause ictal/postictal analgesia. It may be caused by the seizure-related epileptic facilitation of the periaqueductal gray matter; the central pain-inhibiting structure of the brain. Seizure-related endogenous opioid-release my have a contributory role in inhibiting pain-perception. Ictal analgesia warrants better burn-prevention in temporal lobe epilepsy patients. Understanding the mechanism of ictal analgesia and specifying those seizures-types prone to cause it; may help indentifying human pain-inhibiting pathways.

Original languageEnglish
Pages (from-to)173-177
Number of pages5
JournalMedical Hypotheses
Volume85
Issue number2
DOIs
Publication statusPublished - 2015

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Temporal Lobe Epilepsy
Burns
Analgesia
Seizures
Stroke
Epilepsy
Pain
Pain Perception
Wounds and Injuries
Periaqueductal Gray
Partial Epilepsy
Temporal Lobe
Opioid Analgesics
Accidents

ASJC Scopus subject areas

  • Medicine(all)

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Ictal analgesia in temporal lobe epilepsy - The mechanism of seizure-related burns. / Szűcs, A.; Horváth, András; Rásonyi, G.; Fabó, Dániel; Szabó, Géza; Sákovics, Anna; Kamondi, A.

In: Medical Hypotheses, Vol. 85, No. 2, 2015, p. 173-177.

Research output: Contribution to journalArticle

Szűcs, A. ; Horváth, András ; Rásonyi, G. ; Fabó, Dániel ; Szabó, Géza ; Sákovics, Anna ; Kamondi, A. / Ictal analgesia in temporal lobe epilepsy - The mechanism of seizure-related burns. In: Medical Hypotheses. 2015 ; Vol. 85, No. 2. pp. 173-177.
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