Two different seizure networks on the scalp EEG present as ictal eye movements with epileptic nystagmus in a patient with cerebral hyperperfusion syndrome

Cerebral hyperperfusion syndrome (CHS) is a rare complication of carotid revascularization characterized by increased cerebral blood flow, causing symptoms like acute headaches, disorientation, focal neurological deficits, and seizures. Around 3% of individuals experience seizures, primarily due to cerebral edema from hyperperfusion [1]. There have been reports of generalized tonic-clonic seizures and localized motor status epilepticus caused by CHS following carotid artery stenting [1]. Here we present a case of recurrent epileptic seizures originating from different seizure networks that present as ictal eye movements with epileptic nystagmus.

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