Anti-NMDA-receptor antibody-mediated cortical blindness: a case report

Learning point for clinicians A 73-year-old woman underwent laparotomy for perforated duodenal ulcer, presumed secondary to non-steroidal use for back pain. An incidental ten centimetre ovarian dermoid cyst was also resected. Post-operatively she developed sepsis, acute kidney injury, type two respiratory failure, and a transient drop in Glasgow Coma Scale (GCS). Computed tomography (CT) brain was normal. Her level of consciousness recovered spontaneously and she was discharged home symptom-free. Two days later, she re-presented with generalized seizures. CT brain did not show any acute changes. Cerebrospinal fluid (CSF) constituents were normal. She became encephalopathic, with refractory seizures. Examination revealed cortical blindness and right-sided neglect. Electroencephalography (EEG) demonstrated right posterior hemispheric periodic lateralized epileptiform discharges (PLEDs). Repeat CT brain showed …