Abstract：
Pupillary changes can be an important semiologic feature in focal epilepsy. Though the subcortical networks involving pupillomotor function have been described, cortical generators of pupillary dilation and constriction in humans are not well known. In this report, we describe a case of pupillary constriction occurring during seizures in a patient with drug resistant focal epilepsy. On stereoelectroencephalography, onset was noted within the posterior segment of the right intraparietal sulcus and direct cortical electrical stimulation of these electrode contacts reproduced pupillary constriction associated with habitual seizures. This is the first case report to describe ictal pupillary constriction during SEEG with confirmation of the cortical localization by direct cortical electrical stimulation. The posterior segment of the right intraparietal sulcus localization of pupillary constriction may aid in surgical evaluation patients with drug resistant focal epilepsy.
摘要：
瞳孔变化可能是局灶性癫痫的重要符号学特征。尽管已经描述了涉及瞳孔运动功能的皮层下网络，人类瞳孔扩张和收缩的皮质发生器尚不为人所知。在这份报告中,我们描述了一例耐药局灶性癫痫患者在癫痫发作期间发生瞳孔收缩的病例。在立体脑电图上，在右顶内沟的后段发现了发作，这些电极接触的直接皮质电刺激再现了与习惯性癫痫发作相关的瞳孔收缩。这是第一例描述SEEG期间乳头收缩的病例报告，并通过直接皮层电刺激确认了皮层定位。瞳孔收缩的右顶内沟后段定位可能有助于对耐药局灶性癫痫患者进行手术评估。
