Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Clinical presentations of Ross syndrome have changed in their lateralities following the anteriotemporal lobectomy for refractory focal epilepsy

Namiko Henmi, M.D.1), Shuichiro Neshige, M.D., Ph.D.1)2), Akihiro Shimotake, M.D., Ph.D.3), Akio Oishi, M.D., Ph.D.4), Waro Taki, M.D., Ph.D.5), Akio Ikeda, M.D., Ph.D.3) and Ryosuke Takahashi, M.D., Ph.D.1)

1)Department of Neurology, Kyoto University Graduate School of Medicine
2)Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
3)Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine
4)Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine
5)Department of Neurosurgery, Koseikai Takeda Hospital

We describe a 60-year-old woman with medically refractory left mesial temporal lobe epilepsy accompanied by Ross syndrome. The patient had a partial triad of Ross syndrome with hypohydrosis only on her right side (contralateral to the epileptic seizure focus), Adie's tonic pupil on the right, and areflexia while her seizures used to be medically refractory. However, her hypohidrosis and Adie's tonic pupil have completely changed in terms of laterality following nearly complete seizure freedom resutling from left temporal lobectomy. This unique change in laterality in Ross syndrome is most likely caused by remote effects of the near-absent epileptic acitivity, and it also may contribute to understanding the pathophysiological mechanism of Ross syndrome.
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(CLINICA NEUROL, 59: 646|651, 2019)
key words: autonomic nerve, anti-epileptic drug, tonic pupil, deep tendon reflex, complex partial seizure

(Received: 8-May-19)