Aldrich M S, Vanderzant C W, Alessi A G, Abou-Khalil B, Sackellares J C
Department of Neurology, University of Michigan Medical Center, Ann Arbor.
Epilepsia. 1989 Jan-Feb;30(1):116-20. doi: 10.1111/j.1528-1157.1989.tb05292.x.
Cortical blindness is rarely an ictal manifestation. We report the case of a man who developed transient cortical blindness followed by permanent visual deficits during repeated partial seizures. Intermittent visual impairment began at age 14 years. After he had the first generalized seizure at age 28 years, neurologic, ophthalmologic, angiographic, and brain computed tomographic (CT) examinations were normal. Several EEGs showed almost continuous biposterior spike-waves. Over the next several years, frequent partial seizures were associated with transient visual loss and left body twitching or paresthesias. When he was 32, transient blindness occurred during several days of repeated occipital seizures. Permanent left homonymous hemianopia, right homonymous central scotoma, dyschromatopsia, and altered stereopsis followed these seizures. Brain CT demonstrated a new right occipital lesion. Partial seizures arising posteriorly may cause transient cortical blindness and result in permanent visual deficits.
皮质盲很少作为发作期表现。我们报告一例男性病例，该患者在反复部分性发作期间出现了短暂性皮质盲，随后出现永久性视力缺陷。间歇性视力障碍始于14岁。他在28岁首次发生全身性发作后，神经学、眼科、血管造影和脑部计算机断层扫描（CT）检查均正常。多次脑电图显示几乎持续的双侧后颞棘波。在接下来的几年里，频繁的部分性发作与短暂性视力丧失以及左侧身体抽搐或感觉异常有关。32岁时，在几次枕叶发作的数天内出现了短暂性失明。这些发作后出现了永久性左侧同向性偏盲、右侧同向性中心暗点、色觉障碍和立体视觉改变。脑部CT显示右侧枕叶有一个新病灶。后部起源的部分性发作可能导致短暂性皮质盲并导致永久性视力缺陷。
