HEMIANOPIA IN DEMENTIA WITH LEWY BODIES

Objective: To describe the pathologic changes that caused a left homon ymous hemianopsia in a patient with dementia with Lewy bodies. Design: Report of a case and postmortem studies. Main Outcome and Results: A 66-year-old woman experienced parkinsonism and left homonymous hemiano psia early in the course of a rapidly progressive dementia that culmin ated in death only 21 months after the onset of her symptoms. Postmort em examination revealed pathologic features consistent with the diagno sis of dementia with Lewy bodies. The only apparent explanation for he r visual field deficit was a disproportionately large number of neurof ibrillary tangles in the right striate, peristriate, and inferotempora l cortices. Conclusion: A clinically obvious homonymous hemianopsia ca n result from the occipital and inferotemporal cortical degeneration i n dementia with Lewy bodies.