title: Lacrimation as an Ictal Autonomic Event in a Patient With Seizures Originating From the Right Hemisphere.
abstract: In dacrystic seizures lacrimation has previously been reported as an ictal autonomic event accompanying emotional and somatic signs. However, it has not been observed as an isolated event in autonomic seizures. We report a patient experiencing complex partial seizures characterized by lacrimation as the initial and most prominent ictal event, with no sign of crying. The patient's ictal electroencephalogram (EEG) suggested a focus in the right hemisphere, along with interictal single-photon emission computed tomographic (SPECT) and positron emission tomographic (PET) studies demonstrating hypoperfusion-hypometabolism in the right temporoparietal lobe. Magnetic resonance imaging (MRI) did not show any structural abnormalities. Involvement of the temporal lobe has been suggested for dacrystic seizures, and both dominant and nondominant hemispheric foci were detected in such cases. Therefore, partially in concordance with previous reports, our case may point to neurobiologic interaction, between the temporoparietal region and the hypothalamus, for mediating lacrimation.
authors.affiliation: Department of Neurology, School of Medicine, Hacettepe University, Ankara, Turkey evrenerdener@hacettepe.edu.tr.
authors.forename: Sefik Evren
authors.initials: SE
authors.lastname: Erdener
authors.affiliation: Department of Neurology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Nese
authors.initials: N
authors.lastname: Dericioglu
authors.affiliation: Department of Nuclear Medicine, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Eser Lay
authors.initials: EL
authors.lastname: Ergun
authors.affiliation: Department of Neurology, School of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Saygi
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D007839:Functional Laterality; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D009415:Nerve Net / Q000503:physiopathology; D012640:Seizures / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D013666:Tears / Q000378:metabolism; D055815:Young Adult
keywords: autonomic; epilepsy; ictal lacrimation; seizures; temporal lobe