{
  "abstract": "Background Status amauroticus, or ‘ictal blindness’, is a rare neurological syndrome. It is typically unilateral, presenting with homonymous hemianopia. We describe a complete ictal blindness caused by focal status epilepticus from the midline occipital region.Case An 83-year-old independent woman with metastatic cholangiocarcinoma presented after finishing a 5-fluorouracil infusion with acute onset complete blindness, confusion and dysarthria. She had experienced headaches and nausea in the preceding 24 hours, which she had attributed to chemotherapy. On examination, she had no perception of light in either eye. The pupils were 4 mm and reactive, with no relative afferent pupillary defect. There were no ocular abnormalities on the slit lamp examination. She was oriented to time and place but lacked insight into the gravity of her disability. The remainder of the neurological examination was normal. Laboratory markers demonstrated chronic anaemia (91 g/L), thrombocytopenia (95 x10^9/L), and a mildly elevated ESR (37 mm/hr). CT stroke series and MRI (performed ~4hr after symptom onset) were unremarkable. Her symptoms persisted over 72 hours, at which point a 20-minute EEG was performed, which demonstrated three focal seizures from the midline occipital region (O1=O2). She was loaded with levetiracetam and had a complete return of her vision within a few hours. The syndrome did not recur. Lumbar puncture and PET/CT to investigate for an underlying cause of the seizures were uninformative.Conclusions We present a rare case of bilateral occipital focal status epilepticus manifesting as complete ictal blindness, with excellent resolution with antiseizure medications.",
  "authors": [
    {
      "affiliations": [
        "Neurology Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia"
      ],
      "name": "Ross Penninkilampi"
    },
    {
      "affiliations": [
        "Neurology Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia"
      ],
      "name": "Armin Nikpour"
    },
    {
      "affiliations": [
        "Neurology Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia"
      ],
      "name": "Miriam Welgampola"
    }
  ],
  "title": "3646 Status amauroticus: a rare case of focal status epilepticus arising from midline occipital structures",
  "uid": "eab1121e-1f66-56dc-98c9-ae04da6f5816"
}