Acute posterior multifocal placoid pigment epitheliopathy and thalamic infarction.
OBJECTIVE
To report a patient with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) who developed a thalamic infarction and to discuss this unusual presentation.


METHODS
Interventional case report and literature review.


METHODS
A 23-year-old man with APMPPE presented with acute confusion and memory loss. He underwent complete ophthalmologic and neurologic examination, with neuroimaging including magnetic resonance angiography (MRA).


METHODS
Clinical course and angiographic findings.


RESULTS
Magnetic resonance imaging (MRI) showed a left posteromedial thalamic infarction, with a corresponding filling defect of the left posterior communicating artery demonstrated by MRA. The patient underwent further treatment with intravenous corticosteroids followed by continued oral therapy with taper over several weeks.


CONCLUSIONS
Although the association of APMPPE and cerebral vasculitis has been described, this patient is unique due to the subtle clinical presentation and anatomic location. This case emphasizes the importance of appropriate counseling of patients with APMPPE, as well as prompt recognition of clinical symptoms to enable timely intervention and treatment.
From the *Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama; and the †Helen Keller Foundation for Research and Education, Birmingham, Alabama.
Jacob J
JJ
Yunker
Edgar L
EL
Ready
Charles L
CL
Tucker
Robert E
RE
Morris
C Douglas
CD
Witherspoon