Satoh M, Suzuki K, Miyamura M, Katoh R, Kuzuhara S
Department of Neurology, Ise Municipal Hospital.
Rinsho Shinkeigaku. 1997 Jul;37(7):631-5.
A 55-year-old right-handed man suddenly developed unformed visual hallucination of rainbow-colored balls coming out from the lower quadrant of the right visual field. Visual field examination revealed a right lower quadrant homonymous hemianopia. Metamorphopsia of the hand or face appeared 6 days later when he looked at his hands or at the face in the mirror, and persisted for about 10 minutes. 123I-IMP SPECT demonstrated a marked increase in CBF of the left occipital pole while the patient realized the visual symptoms, and a marked decrease in CBF after the symptoms disappeared. T1 and T2-weighted MRIs of the brain were unremarkable, but the Gd-DTPA-enhanced T1-weighted MRI showed high signal in the subcortical white matter of the left occipital pole. The metamorphopsia was induced probably by the activation of the left occipital lesion by the epileptogenic mechanism although the nature of the lesion remained unclarified.
一名55岁的右利手男性突然出现不成形的视幻觉，看到彩虹色的球从右侧视野的下象限出现。视野检查显示右侧下象限同向性偏盲。6天后，当他看自己的手或镜子里的脸时，手或脸出现了视物变形，持续约10分钟。123I-IMP单光子发射计算机断层扫描（SPECT）显示，当患者出现视觉症状时，左侧枕极的脑血流量（CBF）显著增加，症状消失后CBF显著下降。脑部的T1加权和T2加权磁共振成像（MRI）无明显异常，但钆喷酸葡胺（Gd-DTPA）增强的T1加权MRI显示左侧枕极皮质下白质有高信号。尽管病变的性质仍不明确，但视物变形可能是由致痫机制激活左侧枕叶病变所致。
