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Khurram Bashir, MD; Rodger J. Elble, MD, PhD; Mona Ghobrial, MD; Robert G. Struble, PhD

Arch Neurol. 1998;55:1132-1135.

Objective  To describe the pathologic changes that caused a left homonymous 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 hemianopsia early in the course of a rapidly progressive dementia that culminated in death only 21 months after the onset of her symptoms. Postmortem examination revealed pathologic features consistent with the diagnosis of dementia with Lewy bodies. The only apparent explanation for her visual field deficit was a disproportionately large number of neurofibrillary tangles in the right striate, peristriate, and inferotemporal cortices.

Conclusion  A clinically obvious homonymous hemianopsia can result from the occipital and inferotemporal cortical degeneration in dementia with Lewy bodies.

From the Departments of Neurology (Drs Bashir, Elble, and Struble) and Pathology (Drs Ghobrial and Struble) and the Center for Alzheimer Disease and Related Disorders (Drs Elble, Ghobrial, and Struble), Southern Illinois University School of Medicine, Springfield.

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