Anton’s Syndrome due to Bilateral Ischemic Occipital Lobe Strokes

Abstract

We present a case of a patient with Anton's syndrome (i.e., visual anosognosia with confabulations), who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton's syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries.

Anton syndrome as a result of MS exacerbation

“…Apart from imaging, cortical blindness with preserved pupillary reaction to light and accommodation, intact ocular movements, normal optic fundi, absent visual evoked potential, and absent optokinetic nystagmus may all aid in securing a clinical diagnosis of AS. 2,3 New York-Presbyterian Hospital. Author Responds: Nina H. Kim, MD: We thank Dr. Sethi for his interest in our case report.…”

Bilateral cortical visual impairment resulting in Anton's syndrome

“…1 The prognosis for visual recovery in Anton's syndrome can vary based on aetiology but is typically poor. 1,3 Better prognosis has been found in cases of treated hypertensive encephalopathy and cortical hypoperfusion. 1 Improvement in symptoms can occur within three to six months post-injury, with the greatest improvement occurring in the first three months.…”

“…1 The denial of vision loss is termed visual anosognosia. [1][2][3] In addition to bilateral occipital lobe damage, patients with Anton's syndrome may have damage to their visual association cortex, which precludes awareness of their vision loss. 3,4 Patients with Anton's syndrome claim they see and may fabricate entire visual scenarios.…”

“…[1][2][3] In addition to bilateral occipital lobe damage, patients with Anton's syndrome may have damage to their visual association cortex, which precludes awareness of their vision loss. 3,4 Patients with Anton's syndrome claim they see and may fabricate entire visual scenarios. 2,3 Case report A 33-year-old Caucasian male presented to the optometry brain injury clinic for evaluation following an anoxic brain injury secondary to suicide attempt by hanging.…”

“…3,4 Patients with Anton's syndrome claim they see and may fabricate entire visual scenarios. 2,3 Case report A 33-year-old Caucasian male presented to the optometry brain injury clinic for evaluation following an anoxic brain injury secondary to suicide attempt by hanging. The patient was consulted to the service and did not have any visual concerns.…”