A Case of Dacrystic Seizure in a 72-Year-Old Man
Dacrystic seizures are rare, stereotyped episodes of ictal crying. We describe a 72-year-old man with recurrent crying spells, initially attributed to orthostatic hypotension with psychogenic episodes. Electroencephalography monitoring captured interictal left frontal spikes and diffuse background slowing. Magnetic resonance imaging demonstrated a prominent left mesial temporal lesion, though no episodes were identified in the 24-hour monitoring period. The patient was treated with levetiracetam and reported significantly fewer events at home. Clinical response confirms the diagnosis. This case highlights the diagnostic challenge of emotional seizure semiologies and the critical role of multidisciplinary evaluation, particularly for hospitalists encountering atypical neurologic presentations.
