OCCIPITAL STATUS EPILEPTICUS - AN UNUSUAL CASE OF POSTTRAUMATIC BLINDNESS

Post-traumatic seizures can be a cause of multiple clinical and behavi oral abnormalities. We present an unusual case of post-traumatic epile psy resulting in blindness. The patient was a 35-year-old female with a past history of toxemia of pregnancy who was assaulted, sustaining a traumatic brain injury (TBI). Glasgow Coma Score upon presentation to the emergency department was 10. Initial CAT scan was negative. Subse quent MRI revealed occipital edema, On examination, she was found to b e blind in both eyes. Consistent with cortical blindness, extra-ocular movements, pupillary reflexes and fundoscopic examination were normal . Unusual scanning eye movements were noted. Electroencephalography (E EG) revealed epileptiform discharges in both occipital regions consist ent with occipital status epilepticus. Seizures were eventually contro lled with Phenytoin and Phenobarbital, with subsequent conversion to C arbamazepine. Central vision returned, but peripheral sight was never regained, Follow up EEG revealed no evidence of epileptiform activity. Post-traumatic occipital status epilepticus is rare. Cortical blindne ss in TBI patients with minimal occipital pathology on imaging is gene rally transient. This case points out the need for the treating rehabi litation professional to be vigilant in assessing for post-traumatic s eizures in patients with persisting visual deficits.