Bilateral lateral geniculate body lesions causing reversible blindness in a patient with posterior reversible encephalopathy syndrome

• Main Authors: Ummer Karadan, Supreeth Ramesh Naga, Jayakrishnan Chellenton, Abin Ummer, Prathap Reddy Muthyala
• Format: Article
• Language: English
• Published: Royal College of Physicians of Edinburgh 2019-03-01
• Series: The Journal of the Royal College of Physicians of Edinburgh
• Subjects: acute loss of vision; atypical PRES; lateral geniculate body; posterior reversible encephalopathy syndrome
• Online Access: https://www.rcpe.ac.uk/sites/default/files/jrcpe_49_1_naga.pdf
• ISSN: 1478-2715; 2042-8189

Posterior reversible encephalopathy syndrome (PRES) is a completely reversible neuroradiological entity caused by accelerated hypertension, eclampsia, certain cytotoxic drugs and acute renal failure. PRES involves posterior circulation of the brain resulting in various manifestations, hence the name. Acute vision loss is one of the manifestations that occurs owing to the involvement of the visual pathway. However, loss of vision due to a lesion involving the lateral geniculate body alone is unusual. We report one such case of a young female who developed acute bilateral painless loss of vision without any other symptom during postpartum period. MRI brain showed features of PRES involving bilateral lateral geniculate body, hippocampus and brainstem. There was no involvement of retrogeniculate visual pathway, i.e. parieto-occipital cortex. The patient improved with optimal blood pressure control and was discharged after 5 days.