We present three patients with refractory epilepsy and left mesial temporal sclerosis, with ipsilateral subtle post-ictal ptosis, without evident anisocoria (figure 1, table 1), that could be explained by central autonomic dysfunction, similar to postictal bradycardia and asystole , different from both contralateral and ipsilateral ictal ptosis and miosis that have also been described [2, 3]. Not only the dentate gyrus but also the CA1 region of the hippocampus is involved . The amygdala, through the stria terminalis and the amygdalofugal pathways, has a close relationship with the hypothalamus where a decrease in connectivity, ipsilateral to the seizure focus, has been observed . The clinical details of the patients are outlined in figure 1 and table 1.
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