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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Unilateral mydriasis during temporal lobe seizures
Ana M García-Martín1, Francisco J Molina-Martínez, Guiem Amer-Ferrer
1Servicio de Neurología, Hospital Universitario Son Dureta, Palma de Mallorca, Spain. anagmartin@hotmail.com
Summary
Epileptic seizures can cause autonomic symptoms like pupil dilation. This case highlights rare unilateral mydriasis during seizures, linked to a temporal lobe lesion.
Area of Science:
- Neurology
- Autonomic Nervous System Research
- Epileptology
Background:
- Autonomic dysfunction is common in epileptic seizures, often involving sympathetic activation.
- Parasympathetic activation and sympathetic inhibition can also occur, particularly in partial seizures.
- Central autonomic network involvement is hypothesized to cause these autonomic symptoms.
Observation:
- A middle-aged man with a right temporal lobe lesion and hypothalamic extension experienced autonomic symptoms.
- These symptoms included prominent unilateral mydriasis (pupil dilation) and decreased alertness.
- Ictal electroencephalogram and video recording confirmed an epileptic origin.
Findings:
- Unilateral mydriasis during epileptic seizures is an infrequent clinical presentation.
- The patient's symptoms were associated with a focal brain lesion affecting autonomic pathways.
- This case adds to the limited literature on unilateral pupillary changes in epilepsy.
Implications:
- Understanding rare autonomic manifestations like unilateral mydriasis can aid in seizure localization.
- Further research into the neurobiological basis of autonomic symptoms in epilepsy is warranted.
- This case underscores the complex interplay between the brain and autonomic functions during seizures.
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