Pain is a rare manifestation of epileptic seizures. Yet, despite its rarity as a clinical entity, the pain associated with such seizures can be both severe and disabling. It thus remains important to consider epilepsy in the differential diagnosis of unexplained paroxysmal pain. By way of illustration, we present here a report of acute localised paroxysmal pain as the initial manifestation of focal epilepsy with EEG abnormalities in an otherwise neurodevelopmentally normal child. A brief discussion of the literature on epileptic pain then follows.