Improvement of visual field defects after focal resection for occipital lobe epilepsy: case report

Improvement of visual field defects after surgical treatment for occipital lobe epilepsy is rare. Here, the authors report on a 24-year-old man with a 15-year history of refractory epilepsy that developed after he had undergone an occipital craniotomy to remove a cerebellar astrocytoma at the age of 4. His seizures started with an elementary visual aura, followed by secondary generalized tonic-clonic convulsion. Perimetry revealed left-sided incomplete hemianopia, and MRI showed an old contusion in the right occipital lobe. After evaluation with ictal video-electroencephalography, electrocorticography, and mapping of the visual cortex with subdural electrodes, the patient underwent resection of the scarred tissue, including the epileptic focus at the occipital lobe. After surgery, he became seizure free and his visual field defect improved gradually. In addition, postoperative 123I-iomazenil (IMZ) SPECT showed partly normalized IMZ uptake in the visual cortex. This case is a practical example suggesting that neurological deficits attributable to the functional deficit zone can be remedied by successful focal resection.

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Migraine-Like Positive Visual Phenomena Related to Focal Cortical Lesions with Undetectable Visual Field Defects

Case Reports in Ophthalmology ◽

10.1159/000517792 ◽

2021 ◽

pp. 653-658

Author(s):

Amir Vosoughi ◽

Andrew Micieli ◽

Jonathan A. Micieli

Keyword(s):

Visual Field ◽

Visual Fields ◽

Occipital Lobe ◽

Visual Disturbance ◽

Visual Field Defects ◽

Cortical Lesions ◽

Visual Aura ◽

Visual Phenomena ◽

History Of ◽

Field Defects

Migraines are commonly associated with a visual aura that has a characteristic clinical presentation. Cortical lesions within or in close proximity to the retrochiasmal visual pathways may also present in a manner that mimics migrainous visual phenomena and, in some cases, may be too small to manifest with a visual field defect on formal testing. We present 4 patients (3 females and 1 male) with an average age of 48.5 (range 28–67) years who had migraine-like visual disturbances related to a right temporal meningioma, occipital cavernoma, occipital lobe infarction, and demyelination in the optic radiations, which was the presenting sign of multiple sclerosis. No patient underwent neurosurgical intervention, and 1 patient (occipital lobe infarct) had complete resolution of the symptom after initial presentation. All patients had normal visual fields at follow-up and no thinning evident on optical coherence tomography. Our cases emphasize the importance of a history in assessing patients with transient positive visual phenomena and identify pathology that may present without visual field defects. Clinical features that should raise a doubt about a diagnosis of migraine visual aura include the absence of headache, brief visual disturbance lasting <5 min or those lasting >60 min, and age >40, especially with no past medical history of migraine.

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Statokinetic Dissociation (Riddoch Phenomenon) in a Patient with Homonymous Hemianopsia as the First Sign of Posterior Cortical Atrophy

Case Reports in Neurology ◽

10.1159/000481304 ◽

2017 ◽

Vol 9 (3) ◽

pp. 256-260 ◽

Cited By ~ 2

Author(s):

Ryuichiro Hayashi ◽

Shigeki Yamaguchi ◽

Toshio Narimatsu ◽

Hiroshi Miyata ◽

Yasushi Katsumata ◽

...

Keyword(s):

Visual Cortex ◽

Visual Field ◽

Cortical Atrophy ◽

Visual Field Defects ◽

Posterior Cortical Atrophy ◽

Unilateral Neglect ◽

Homonymous Hemianopsia ◽

Kinetic Perimetry ◽

The Right ◽

Field Defects

We report a 60-year-old woman with posterior cortical atrophy (PCA) who presented with left homonymous hemianopsia persisting for 5 years; the patient’s condition was observed using static, but not kinetic, perimetry. This statokinetic dissociation of hemianopsia, which is often called Riddoch syndrome, might have been caused by a dysfunction of the right primary visual and visual association cortices, representing a functional imbalance within a disturbed visual cortex. In patients with PCA and visual field defects, both static and kinetic perimetry may be useful for understanding the extent of degeneration in the visual cortex, in addition to examinations of unilateral neglect.

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Visual Field Defects in Alzheimer???s Disease Patients May Reflect Differential Pathology in the Primary Visual Cortex

Optometry and Vision Science ◽

10.1097/00006324-199611000-00001 ◽

1996 ◽

Vol 73 (11) ◽

pp. 677-682 ◽

Cited By ~ 44

Author(s):

R A ARMSTRONG

Keyword(s):

Visual Cortex ◽

Visual Field ◽

Primary Visual Cortex ◽

Visual Field Defects ◽

Field Defects

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Characteristic Visual Field Defects of Patients with Occipital Lobe Infarction: Homonymous Hemianopia and Macular Sparing

Advances in Visual Science and Eye Diseases - Optic Disorders and Visual Field ◽

10.1007/978-981-13-2502-1_53 ◽

2019 ◽

pp. 517-526

Author(s):

Xiaobin Xie ◽

Ning Fan ◽

Ningli Wang

Keyword(s):

Visual Field ◽

Occipital Lobe ◽

Homonymous Hemianopia ◽

Visual Field Defects ◽

Field Defects ◽

Macular Sparing

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Transitory and permanent visual field defects induced by occipital lobe seizures

The Italian Journal of Neurological Sciences ◽

10.1007/s100720050048 ◽

1999 ◽

Vol 20 (5) ◽

pp. 321-325 ◽

Cited By ~ 4

Author(s):

G. Valli ◽

S. Zago ◽

A. Cappellari ◽

A. Bersano

Keyword(s):

Visual Field ◽

Occipital Lobe ◽

Visual Field Defects ◽

Field Defects

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Clinical Study of the Visual Field Defects Caused by Occipital Lobe Lesions

Cerebrovascular Diseases ◽

10.1159/000356848 ◽

2014 ◽

Vol 37 (2) ◽

pp. 102-108 ◽

Cited By ~ 5

Author(s):

Katsuhiko Ogawa ◽

Hiroshi Ishikawa ◽

Yutaka Suzuki ◽

Minoru Oishi ◽

Satoshi Kamei

Keyword(s):

Clinical Study ◽

Visual Field ◽

Occipital Lobe ◽

Visual Field Defects ◽

Field Defects

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Eye-tracking-based visual field analysis (EFA): a reliable and precise perimetric methodology for the assessment of visual field defects

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2019-000429 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000429

Author(s):

Michael Christian Leitner ◽

Florian Hutzler ◽

Sarah Schuster ◽

Lorenzo Vignali ◽

Patrick Marvan ◽

...

Keyword(s):

Eye Movements ◽

Visual Field ◽

Eye Tracking ◽

Field Analysis ◽

Visual Field Defects ◽

Test Duration ◽

Automated Perimetry ◽

The Individual ◽

The Right ◽

Field Defects

ObjectiveSeveral studies report evidence for training-related neuroplasticity in the visual cortex, while other studies suggest that improvements simply reflect inadequate eye fixation control during perimetric prediagnostics and postdiagnostics.Methods and analysisTo improve diagnostics, a new eye-tracking-based methodology for visual field analysis (eye-tracking-based visual field analysis (EFA)) was developed. The EFA is based on static automated perimetry and additionally takes individual eye movements in real time into account and compensates for them. In the present study, an evaluation of the EFA with the help of blind spots of 58 healthy participants and the individual visual field defects of 23 clinical patients is provided. With the help of the EFA, optical coherence tomography, Goldmann perimetry and a Humphrey field analyser, these natural and acquired scotomas were diagnosed and the results were compared accordingly.ResultsThe EFA provides a SE of measurement of 0.38° for the right eye (OD) and 0.50° for the left eye (OS), leading to 0.44° of visual angle for both eyes (OU). Based on participants’ individual results, the EFA provides disattenuated correlation (validity) of 1.00 for both OD and OS. Results from patients suffering from cortical lesions and glaucoma further indicate that the EFA is capable of diagnosing acquired scotoma validly and is applicable for clinical use.ConclusionOutcomes indicate that the EFA is highly reliable and precise in diagnosing individual shape and location of scotoma and capable of recording changes of visual field defects (after intervention) with unprecedented precision. Test duration is comparable to established instruments and due to the high customisability of the EFA, assessment duration can be shortened by adapting the diagnostic procedure to the patients’ individual visual field characteristics. Therefore, the saccade-compensating methodology enables researchers and healthcare professionals to rule out eye movements as a source of inaccuracies in pre-, post-, and follow-up assessments.

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