levetiracetam and Blindness

Postoperative blindness is a devastating surgical complication. Although usually associated with prolonged cardiac and prone spinal operations, it may follow other procedures as well. Postoperative blindness is most commonly caused by a vascular etiology, but it can more rarely be caused by status epilepticus. We have previously reported a case of this phenomenon following a staged spinal deformity surgery.. Here we report 2 additional cases following a skull base procedure and a single stage lumbar spine surgery. In all instances, rapid recognition that the patients' blindness was due to occipital seizures resulted in acute antiepileptiform treatment and full restoration of vision.. Although a rare phenomenon, this syndrome, first recognized and described by Tarik F. Ibrahim, should be considered in any patient with postoperative visual impairment.

Topics: Aged; Anticonvulsants; Blindness; Brain Neoplasms; Electroencephalography; Epilepsies, Partial; Female; Humans; Levetiracetam; Lumbar Vertebrae; Occipital Lobe; Postoperative Complications; Skull Base; Spinal Stenosis; Status Epilepticus

Norrie disease is an X-linked recessive disorder that is characterized by congenital blindness. Although epileptic seizures are observed in some patients with Norrie disease, little is known about this phenomenon. Here, we report the manifestation of epilepsy in siblings with Norrie disease to increase our knowledge of epilepsy in this condition. Three brothers with congenital blindness were diagnosed with Norrie disease after genetic analyses indicated the deletion of exon 2 of the NDP gene. The eldest brother had suffered from epileptic seizures since the age of 11years, and his seizures were resistant to antiepileptic drugs. Although the second brother had no epileptic seizures, the youngest sibling had experiences epileptic seizures since the age of 8years. His seizures were controlled using lamotrigine and levetiracetam. An electroencephalography (EEG) revealed epileptiform discharges in the occipital areas in all three brothers. A study of these patients will increase our knowledge of epilepsy in patients with Norrie disease.

Topics: Anticonvulsants; Blindness; Chromosomes, Human, X; Electroencephalography; Epilepsy; Eye Proteins; Genetic Diseases, X-Linked; Humans; Lamotrigine; Levetiracetam; Nerve Tissue Proteins; Nervous System Diseases; Pedigree; Phenotype; Piracetam; Retinal Degeneration; Siblings; Spasms, Infantile; Triazines