Short-term Vision Loss Following Whipple Surgery: A Case Report.
Occipital seizures may result in visual deficits and may be an ictal or postictal phenomenon. A 71-year-old woman underwent pancreatoduodenectomy (Whipple procedure). During recovery in the postanesthesia care unit, the patient complained of blindness. Upon transfer to the intensive care unit, an electroencephalogram indicated bilateral occipital and hemispheric seizure activity. The patient was treated with antiseizure medication, and vision normalized within 3 days. Subtherapeutic concentration of free phenytoin was confirmed. Our experience suggests that electroencephalogram evaluation should be considered in the workup of postoperative patients who present with acute-onset blindness and in whom the cause remains ambiguous even in the absence of obvious clinical signs of seizures.
From the Department of Anesthesiology, Detroit Medical Center/Wayne State University, Detroit, Michigan.
Lakshman
L
Gollapalli
Aashish J
AJ
Kumar
Kunal
K
Sood
Rudram
R
Muppuri
D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology*; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
D000927:Anticonvulsants