Dachristic seizures are characterized by ictal crying during complex partial seizures expressed as an unconscious behavior without sadness. Researchers at the Epilepsy Monitoring Unit, Mayo Clinic, Jacksonville, FL, report a 32-year-old right-handed woman with drug resistant seizures consisting of an aura followed by staring, and crying without sadness or lacrimation. She had a history of a complex febrile seizure and status epilepticus at 10 months of age, followed by afebrile seizures in adolescence. Presurgical MRI showed left mesial temporal sclerosis. Wada testing revealed left hemisphere language dominance, and left hemisphere injection of sodium methohexital produced immediate speech arrest, right hemiplegia, and crying characteristic of the habitual seizures. Concomitant EEG revealed left hemisphere slowing. Left amygdalohippocampectomy was followed by seizure freedom for more than 2 years on tapering doses of carbamazepine. [1]

COMMENT. In pediatric patients, hypothalamic hamartoma and temporal lobe epilepsy are the most common localization for dachristic seizures, a rare form of epilepsy. [2]