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Epilepsy causing pupillary hippus: an unusual semiology
journal contribution
posted on 2023-06-08, 13:57 authored by Maria Centeno, Maria Feldmann, Neil Harrison, Fergus J Rugg-Gunn, Umair Chaudhary, Carles Falcon, Louis Lemieux, Maria Thom, Shelagh J M Smith, Sanjay M SisodiyaAltered 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
History
Publication status
- Published
Journal
EpilepsiaISSN
1528-1167Publisher
Wiley-BlackwellExternal DOI
Issue
8Volume
52Article number
e93-e96Department affiliated with
- Clinical and Experimental Medicine Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2012-11-28Usage metrics
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