Nasal Pain as an Aura to a Complex Partial Seizure

Case History A 6-year-old right hand–dominant male presented to the emergency room with a 3-month history of episodes described as starting with a stinging sensation at the tip of the nose. A literature review has revealed only one similar report, in which a patient presented with focal pain to the right ala of the nose with contralateral eye and head version followed by generalized tonic activity with no reported vasomotor or autonomic changes.1 The left temporal focus of the EEG does suggest a few different sources of the seizure onset and helps with localization given the normal MRI, although the ictal semiology does not help with lateralization of the ictal symptomatogenic zone. [...]an ictal onset within the right temporal lobe with rapid spread to the left cannot be discounted either.