Goldstein M J, Parker R L, Dewan D M
Department of Anesthesia (Section of Obstetric Anesthesia), Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, USA.
Reg Anesth. 1996 Nov-Dec;21(6):595-8.
A patient who underwent cesarean delivery with epidural anesthesia presented 6 days postpartum with acute cortical blindness.
Initial studies included an ophthalmology consultation as well as a full neurologic workup, including cranial computed tomography, diagnostic lumbar puncture, magnetic resonance imaging, body fluid cultures, and electroencephalography. Early broad-spectrum antibiotic coverage was initiated, and because of possible epileptic activity on electroencephalogram, phenytoin was added to the treatment regimen.
Soon after beginning the initial phenytoin dose, the patient reported full return of her vision. She was eventually discharged from the hospital in good condition.
This case report illustrates how blindness can be related to seizure activity.
一名接受硬膜外麻醉剖宫产的患者在产后6天出现急性皮质盲。
初始检查包括眼科会诊以及全面的神经学检查,包括头颅计算机断层扫描、诊断性腰椎穿刺、磁共振成像、体液培养和脑电图检查。开始早期广谱抗生素治疗,由于脑电图上可能存在癫痫活动,在治疗方案中加入了苯妥英。
在开始使用初始剂量的苯妥英后不久,患者报告视力完全恢复。她最终康复出院。
本病例报告说明了失明如何与癫痫活动相关。