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May 31, 2016: Dacrystic seizures

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May 31, 2016

Dacrystic seizures

Dacrystic seizures are rare, occurring with an estimated frequency of 0.13% in patients admitted for long-term video monitoring.1 Seizures are characterized by stereotyped crying and may encompass lacrimation, sobbing, or sad facial expression. They most commonly occur along with gelastic seizures and/or generalized tonic-clonic seizures. A hypothalamic hamartoma is usually the cause when patients have both dacrystic and gelastic seizures, whereas isolated dacrystic seizures are typically associated with mesial temporal sclerosis. The proposed pathophysiology is thought to be from excitation of neurons in the hypothalamus or secondary to a hypothalamic autonomic release phenomenon from disinhibited regulatory cortex. Dacrystic seizures are often medically refractory, with no guaranteed improvement after epilepsy surgery.

  1. Blumberg J, Fernández IS, Vendrame M, et al. Dacrystic seizures: demographic, semiologic, and etiologic insights from a multicenter study in long-term video-EEG monitoring units. Epilepsia 2012; 53: 1810-1819.

Submitted by Michael Young, DO, PGY-3, Department of Neurology, University of California, Irvine Medical Center.

Dr. Young reports no disclosures.

For more clinical pearls and other articles of interest to neurology trainees, visit Neurology.  Listen to this week's Neurology Podcast.

 

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