EpistemisQuadrantopsia
Specialty: Neurology.
Why it occurs
- Ischemic stroke in the middle or posterior cerebral artery with localized damage to the temporal lobe (superior homonymous quadrantpsia or "foot in the sky") or the parietal lobe (inferior homonymous quadrantpsia or "pie on the ground")
- Surgical temporal lobectomy (common sequelae in epilepsy surgery)
- Focal parietal or occipito-temporal brain tumors
- Multiple sclerosis with partial demyelination in Meyer's loop or superior optic radiation
- Occipital arteriovenous malformations
Initial workup
Automated static computerized campimetry to map visual quadrant loss; High-resolution 3 Tesla brain MRI to identify millimetric structural lesions along the temporal (Meyer's loop) or parietal optical radiations.
red flags
New-onset acute quadrantopsia associated with alexia without agraphia (inability to read with preservation of writing, typical of left occipital lesions affecting the posterior corpus callosum) or color agnosia, suggesting ischemia in the territory of the left posterior cerebral artery.
Standard management
- Statins and antiplatelet agents in case of causative cerebral atherothrombotic pathology
- Prismatic visual rehabilitation and saccadic movement training to compensate for the visual field defect and improve the patient's daily performance.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Neurology
- Listed causes
- 5
- Treatment options
- 2