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Case Reports
Status Epilepticus Amauroticus Secondary to Meningitis as a Cause of Postpartum Cortical Blindness
  1. Marilyn J. Goldstein, M.D.*,
  2. Lamar R. Parker, M.D† and
  3. David M. Dewan, M.D*
  1. *Departments of Anesthesia (Section of Obstetric Anesthesia) and
  2. †Obstetrics and Gynecology, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina
  1. Reprint requests: Dr. Marilyn J. Goldstein, Department of Anesthesia, Bowman Gray School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1009.

Abstract

Background and Objectives A patient who underwent cesarean delivery with epidural anesthesia presented 6 days postpartum with acute cortical blindness.

Methods 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.

Results 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.

Conclusions This case report illustrates how blindness can be related to seizure activity.

  • cortical blindness
  • ictal blindness
  • meningitis
  • postpartum blindness
  • status epilepticus amauroticus

http://dx.doi.org/10.1136/rapm-00115550-199621060-00017

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