PMC9082191_01
Fundus photographs at the time of re-examination. Right eye (a), Left eye (b). No significant changes other than glaucomatous optic nerve papillary cupping and disc hemorrhage were observed.
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F1
The anterior segment of the eye was clear with an intraocular lens, and there were no significant changes in the fundus, except for a left papillary hemorrhage (Fig. 1).
Automatic visual field meter at re-examination. Visual field test results showed an MD, -8.73 dB; and PSD, 8.32 dB; in the left eye (a), and an MD, -6.65 dB; and PSD, 8.00 dB; in the right eye (b), indicating left lower 1/4 homonymous hemianopsia; however, no significant change was observed from previous examination.
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F2
Visual field test results showed an MD, -6.65 dB; and PSD, 8.00 dB; in the right eye, and an MD, -8.73 dB; and PSD, 8.32 dB; in the left eye, indicating left lower 1/4 homonymous hemianopsia; however, no significant change was observed from previous examination (Fig. 2).
a MRI image performed at the neurosurgical hospital revealing a left obsolete occipital lobe infarction (arrow). b ASL image showing decreased blood flow in the same region (arrow). ASL, arterial spin labeling; MRI, magnetic resonance imaging.
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F3
The patient voluntarily visited a neurosurgery hospital 2 days later and underwent magnetic resonance imaging, which revealed no other findings except for a left obsolete cerebral infarction with decreased blood flow in the arterial spin labeling (Fig. 3).
A sketch of the visual hallucination brought by the patient. The patient stated that she saw colorful globular objects like polka dots swirling from her right shoulder downward. This is very similar to a previous report of visual hallucinations in OLE.
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F4
Five days after her visit to our clinic, she complained that she saw many colored spherical objects, such as water balloons moving from her right shoulder downward (Fig. 4).
EEG. a During the seizure, spike and wave were noted predominantly in the occipital lobe. b Later, the seizure became generalized, and spike and wave were noted in the whole area.
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F5
The EEG revealed a predominantly occipital lobe spike and wave, followed by a generalized spike and wave (Fig. 5).