Ischemic oculo-pyramidal crossed syndrome, i.e. amaurosis fugax contralateral to hemiparesis, is caused by an embolus from internal carotid artery occluding the retinal or the ophthalmic artery as well as the middle cerebral artery. We report on a patient with an oculopyramidal crossed syndrome due to internal carotid artery dissection and clinically manifesting with amaurosis fugax and seizure. Ischemic lesions can present with symptomatic seizures and, conversely, seizures may precede ischemic strokes, thus being a warning sign of a cerebrovascular event.