Crying with left temporal lobe seizures and Wada testing

Dacrystic seizures are characterized by crying and are rare in patients with epilepsy. The crying that occurs during complex partial seizures is expressed as an unconscious behavior unassociated with sadness or depressive quality. It has been reported to occur with focal seizures that are localized to the frontotemporal regions and is frequently lateralized to the nondominant hemisphere. We describe a woman with left temporal lobe epilepsy and recurrent complex partial seizures with crying behavior that was reproduced during left carotid methohexital anesthesia, suggesting functional inactivation by two different mechanisms. Following left amygdalohippocampectomy she became seizure free for >2years without perioperative mood destabilization. Localized functional networks that involve limbic structures may be involved in patients with dacrystic seizures with a favorable outcome following epilepsy surgery.