de Souza Andrade Thais, Mello Luiz Guilherme Marchesi, Hokazono Kenzo, Monteiro Mário Luiz Ribeiro
Division of Ophthalmology and the Laboratory of Investigation in Ophthalmology (LIM 33), University of São Paulo Medical School, São Paulo, Brazil.
Department of Specialized Medicine, Centro de Ciências da Saúde (CCS), Universidade Federal do Espírito Santo, Vitória, Brazil.
Neuroophthalmology. 2022 Dec 15;47(2):117-122. doi: 10.1080/01658107.2022.2153873. eCollection 2023.
We evaluated a 48-year-old woman who had visual hallucinations (VHs) as a major presenting sign of posterior reversible encephalopathy syndrome (PRES). Despite her mild loss of vision, she described various hallucinations after awakening from a comatose state days after a motorcycle collision. VHs are usually accompanied by more severe loss of vision, yet our case and literature review indicate that sudden onset of formed VHs should suggest a possible diagnosis of PRES in patients who have large fluctuations in blood pressure, renal failure, or autoimmune dysfunction, as well as in patients taking cytotoxic agents.
我们评估了一名48岁女性，她以视幻觉（VHs）作为后部可逆性脑病综合征（PRES）的主要表现症状。尽管她有轻度视力丧失，但在摩托车碰撞后数天从昏迷状态苏醒后，她描述了各种幻觉。视幻觉通常伴有更严重的视力丧失，然而我们的病例及文献回顾表明，对于血压大幅波动、肾衰竭或自身免疫功能障碍的患者以及正在服用细胞毒性药物的患者，突发的成形视幻觉应提示可能为后部可逆性脑病综合征。
