Lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery: A case report

Background Ictal epileptic headache is a very rare form of painful seizure that closely mimics several classic headache syndromes, including trigeminal neuralgia. Case Here, we present a woman who was treated as for treatment-refractory unilateral trigeminal neuralgia over 10 years, which was later...

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Main Authors: Demuni P Jayasena, Karunanayaka A S K Karunanayaka, Sudath Gunasekara, Pathberiyage L S Pathberiya, Sanjeewa Garusinghe, Amila Chandrakumara, Sunethra Senanayake, Inuka K Gooneratne
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Cephalalgia Reports
Online Access:https://doi.org/10.1177/25158163251342806
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author Demuni P Jayasena
Karunanayaka A S K Karunanayaka
Sudath Gunasekara
Pathberiyage L S Pathberiya
Sanjeewa Garusinghe
Amila Chandrakumara
Sunethra Senanayake
Inuka K Gooneratne
author_facet Demuni P Jayasena
Karunanayaka A S K Karunanayaka
Sudath Gunasekara
Pathberiyage L S Pathberiya
Sanjeewa Garusinghe
Amila Chandrakumara
Sunethra Senanayake
Inuka K Gooneratne
author_sort Demuni P Jayasena
collection DOAJ
description Background Ictal epileptic headache is a very rare form of painful seizure that closely mimics several classic headache syndromes, including trigeminal neuralgia. Case Here, we present a woman who was treated as for treatment-refractory unilateral trigeminal neuralgia over 10 years, which was later deemed to be due to somatosensory seizures from the insular cortex. A cavernous haemangioma in the right insular cortex was identified as the causative lesion for these recurrent seizures and was successfully treated with resective surgery. Conclusion This case underscores the importance of considering lesional ictal epileptic headaches as a differential diagnosis of treatment-resistant neuralgiform headaches, which can be effectively managed by targeted surgical resection thereby inducing long-term headache or seizure remission.
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id doaj-art-0cd8ce3af3eb43cb862b497810b9dc38
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issn 2515-8163
language English
publishDate 2025-05-01
publisher SAGE Publishing
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series Cephalalgia Reports
spelling doaj-art-0cd8ce3af3eb43cb862b497810b9dc382025-08-20T02:34:13ZengSAGE PublishingCephalalgia Reports2515-81632025-05-01810.1177/25158163251342806Lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery: A case reportDemuni P Jayasena0Karunanayaka A S K Karunanayaka1Sudath Gunasekara2Pathberiyage L S Pathberiya3Sanjeewa Garusinghe4Amila Chandrakumara5Sunethra Senanayake6Inuka K Gooneratne7 Department of Clinical Sciences, , Rathmalana, Sri Lanka Institute of Neurology, , Colombo, Sri Lanka East and North Hertfordshire NHS Trust, , Hertford, UK Institute of Neurology, , Colombo, Sri Lanka Institute of Neurology, , Colombo, Sri Lanka Institute of Neurology, , Colombo, Sri Lanka Institute of Neurology, , Colombo, Sri Lanka Department of Medicine and Mental Health, Faculty of Medicine, , Moratuwa, Sri LankaBackground Ictal epileptic headache is a very rare form of painful seizure that closely mimics several classic headache syndromes, including trigeminal neuralgia. Case Here, we present a woman who was treated as for treatment-refractory unilateral trigeminal neuralgia over 10 years, which was later deemed to be due to somatosensory seizures from the insular cortex. A cavernous haemangioma in the right insular cortex was identified as the causative lesion for these recurrent seizures and was successfully treated with resective surgery. Conclusion This case underscores the importance of considering lesional ictal epileptic headaches as a differential diagnosis of treatment-resistant neuralgiform headaches, which can be effectively managed by targeted surgical resection thereby inducing long-term headache or seizure remission.https://doi.org/10.1177/25158163251342806
spellingShingle Demuni P Jayasena
Karunanayaka A S K Karunanayaka
Sudath Gunasekara
Pathberiyage L S Pathberiya
Sanjeewa Garusinghe
Amila Chandrakumara
Sunethra Senanayake
Inuka K Gooneratne
Lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery: A case report
Cephalalgia Reports
title Lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery: A case report
title_full Lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery: A case report
title_fullStr Lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery: A case report
title_full_unstemmed Lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery: A case report
title_short Lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery: A case report
title_sort lesional insular epilepsy mimicking treatment refractory trigeminal neuralgia effectively treated with epilepsy surgery a case report
url https://doi.org/10.1177/25158163251342806
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