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Summary
Transient ictal nystagmus and cortical blindness in acute cerebral disorders can be missed in confused patients. This case highlights these symptoms in a leukemia patient post-bone marrow transplant due to occipital ischemia.
Area of Science:
- Neurology
- Hematology
- Ophthalmology
Background:
- Acute cerebral disorders can cause transient neurological symptoms like ictal nystagmus and cortical blindness.
- These symptoms may be overlooked in patients with altered mental status, such as those who are confused or agitated.
- Bone marrow transplantation is a complex procedure with potential neurological complications.
Observation:
- A case report details a young woman with chronic myelogenous leukemia undergoing bone marrow transplantation.
- The patient experienced progressive illness following the procedure.
- During her illness, she developed acute ictal nystagmus and subsequent cortical blindness with visual hallucinations.
Findings:
- The patient's ictal nystagmus originated from focal ischemia in the right occipital lobe.
- Post-ictal phase included a 48-hour period of cortical blindness.
- Visual hallucinations were also reported during the cortical blindness phase.
Implications:
- This case underscores the importance of recognizing transient visual disturbances in acute neurological events.
- Occipital ischemia can manifest with nystagmus and temporary cortical blindness, especially in immunocompromised patients.
- Prompt diagnosis and management of such neurological complications are crucial in post-transplant care.