title: Anton-Babinski syndrome in an old patient: a case report and literature review.
abstract: Anton-Babinski syndrome is a rare disease featuring bilateral cortical blindness and anosognosia with visual confabulation, but without dementia or any memory impairment. It has a unique neuropsychiatric presentation and should be highly suspected in those with odd visual loss and imaging evidence of occipital lobe injury. In the case discussed herein, a 90-year-old man presented with bilateral blindness, obvious anosognosia, and vivid visual confabulation, which he had had for 3 days. Brain computed tomography demonstrated recent hypodense infarctions at the bilateral occipital lobes. Thus, the patient was diagnosed with Anton-Babinski syndrome. Because of his age and the thrombolytic therapy during the golden 3 hours after ischemic stroke, the patient received aspirin therapy rather than tissue plasminogen activator or warfarin. He gradually realized he was blind during the following week, but died of pneumonia 1 month later. In the literature, it is difficult to establish awareness of blindness in patients with Anton-Babinski syndrome, but optimistically, in one report, a patient was aware of blindness within 2 weeks, without vision improvement. Our case illustrates that elderly patients with Anton-Babinski syndrome can partially recover and that 1 week is the shortest time for the establishment of awareness of blindness for sufferers without vision improvement.
authors.affiliation: Department of Neurology, Neuro-Medical Scientific Center, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan.
authors.forename: Jiann-Jy
authors.initials: JJ
authors.lastname: Chen
authors.forename: Hsin-Feng
authors.initials: HF
authors.lastname: Chang
authors.forename: Yung-Chu
authors.initials: YC
authors.lastname: Hsu
authors.forename: Dem-Lion
authors.initials: DL
authors.lastname: Chen
mesh_terms: D000369:Aged, 80 and over; D001364:Awareness / Q000502:physiology; D001766:Blindness / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D019575:Blindness, Cortical / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D002544:Cerebral Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology; D006801:Humans; D008297:Male; D009778:Occipital Lobe / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
keywords: Anton-Babinski syndrome; blind anosognosia; cortical blindness; occipital lobe infarction; visual confabulation