Postictal hemifacial purpura

Seizure. 1998 Aug;7(4):337-9. doi: 10.1016/s1059-1311(98)80029-0.

Abstract

Non-traumatic stereotyped postictal purpura is rare. A 25-year-old woman presented with right facial, cheek and periorbital purpuric eruptions that occurred after secondarily generalized tonic-clonic seizures. The stereotyped, invariably right-sided facial skin eruption, which resolved in 48 hours, falsely raised concerns of spousal abuse. Possible pathophysiological mechanisms include: (a) valsalva-induced capillary hypertension with secondary purpura, (b) ictal corticolimbic stimulation of the autonomic nervous innervation of facial vasomotor structures, and (c) trigeminal-mediated local release of vasoactive substances. Although rare, such stereotyped patterns of purpura should be recognized to avoid incorrect attribution of spousal abuse.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Epilepsy, Tonic-Clonic / complications*
  • Face
  • Facial Injuries / diagnosis
  • Female
  • Humans
  • Purpura / diagnosis
  • Purpura / etiology*
  • Purpura / physiopathology
  • Spouse Abuse
  • Vasomotor System