Epilepsy causing pupillary hippus: an unusual semiology

Centeno, Maria, Feldmann, Maria, Harrison, Neil A, Rugg-Gunn, Fergus J, Chaudhary, Umair, Falcon, Carles, Lemieux, Louis, Thom, Maria, Smith, Shelagh J M and Sisodiya, Sanjay M (2011) Epilepsy causing pupillary hippus: an unusual semiology. Epilepsia, 52 (8). e93-e96. ISSN 1528-1167

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Altered pupillary behavior is commonly present during and following epileptic seizures, but symptomatic pupillary hippus as the main feature of a seizure has not been reported in the modern literature. We present the case of a woman with epileptic seizures consisting of sustained fluctuation of perception of brightness. Bilateral pupillary hippus is the main semiologic feature.This autonomic phenomenon is selective for the pupils and does not involve other autonomic-mediated responses. An ictal video illustrates this phenomenon. The epileptogenic region, determined by ictal scalp and intracranial electroencephalography (EEG), is localized in the right posterior parietooccipital areas. Pupillary reflexes can be overridden by cortical input; here authors review the literature and discus the physiologic mechanisms underlying this autonomic phenomenon. Fluctuation in perceptual brightness during epileptic seizures may have a basis in ictal pupillary hippus

Item Type: Article
Keywords: Hippus; Autonomic seizures; Tuberous sclerosis complex; EEG-fMRI. STIMULATION; DILATATION
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Brighton and Sussex Medical School > Neuroscience
Subjects: R Medicine > R Medicine (General) > R895 Medical physics. Medical radiology. Nuclear medicine
R Medicine > RC Internal medicine > RC0321 Neurosciences. Biological psychiatry. Neuropsychiatry
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Depositing User: Hazelle Woodhurst
Date Deposited: 28 Nov 2012 10:47
Last Modified: 26 Sep 2017 11:40
URI: http://srodev.sussex.ac.uk/id/eprint/43086
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