Episodic pain associated with a tumor in the parietal operculum: a case report and literature review

Abstract

We report a young woman suffering brief painful episodes in her right arm which sometimes spread to the whole right side of her body. The episodes were initially rare, but over 13 months they became increasingly frequent until occurring every 20 min. Neurological examination was normal. Magnetic resonance imaging revealed a lesion in the white matter of the parietal operculum. Lesions in the parietal operculum associated with persisting thalamic pain or loss of pain sensation have been reported, but rarely with episodic pain. Since episodic painful attacks have been described in association with various suprathalamic lesions, we conclude that paroxysmal pain attacks may be another consequence of the disturbance of the normal pattern of thalamocortical connections to the second sensory cortical area by a lesion, in our case, of the subcortical area of the parietal operculum.

Mechanical Noxious Stimuli Cause Bilateral Activation of Parietal Operculum in Callosotomized Subjects

“…Indeed, the nearly identical latencies of activation of contralateral SI and SII (Kanda et al, 2000;Ploner et al, 2000) and of contralateral and ipsilateral SII (Frot and Mauguière, 1999a;Ploner et al, 1999;Kanda et al, 2000) suggest a major role for SII in pain processing (Treede et al, 2000). The altered pain sensitivity reported in patients with lesions involving PO (Greenspan and Winfield, 1992;Potagas et al, 1997;Greenspan et al, 1999) is in line with these data.…”

Painful seizures with allodynia in an 11–year‐old boy

“…Lesions of the insula and the parietal operculum produce tactile and pain deficits but may also produce allodynia on the contralateral hemibody (Michel et al 1990, Masson et al 1991, Greenspan and Winfield 1992. Episodic pain has also been associated with lesions of the parietal operculum (Potagas et al 1997). Bilateral asymbolia to pain has been demonstrated after lesion of the insula (Masson et al 1991).…”