Postictal hemifacial purpura

Jacques J. Reis, Peter W. Kaplan

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)337-339
Number of pages3
Issue number4
StatePublished - 1998


  • 'Slapped face'
  • Ictal sequelae
  • Petechiae
  • Postictal hemifacial purpura

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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