Reversible postoperative blindness caused by bilateral status epilepticus amauroticus following thoracolumbar deformity correction: case report Journal Article

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Authors: Ibrahim, T. F.; Sweis, R. T.; Nockels, R. P.
Article Title: Reversible postoperative blindness caused by bilateral status epilepticus amauroticus following thoracolumbar deformity correction: case report
Abstract: Postoperative vision loss (POVL) is a devastating complication and has been reported after complex spine procedures. Anterior ischemic optic neuropathy and posterior optic neuropathy are the 2 most common causes of POVL. Bilateral occipital lobe seizures causing complete blindness are rare and have not been reported as a cause of POVL after spine surgery with the patient prone. The authors report the case of a 67-year-old man without a history of seizures who underwent a staged thoracolumbar deformity correction and developed POVL 6 hours after surgery. Imaging, laboratory, and ophthalmological examination results were nonrevealing. Routine electroencephalography study results were negative, but continuous electroencephalography captured bilateral occipital lobe seizures. The patient developed nonconvulsive status epilepticus despite initial treatment with benzodiazepines and loading doses of levetiracetam and lacosamide. He was therefore intubated for status epilepticus amauroticus and received a midazolam infusion. After electrographic seizure cessation for 48 hours, the patient was weaned off midazolam. The patient was maintained on levetiracetam and lacosamide without seizure recurrence and returned to his preoperative visual baseline status.
Journal Title: Journal of neurosurgery.Spine
ISSN: 1547-5646; 1547-5646
Publisher: Unknown  
Journal Place: United States
Date Published: 2017
Start Page: 1
End Page: 5
Language: eng
DOI/URL:

10.3171/2016.12.SPINE16540
Notes: LR: 20170421; JID: 101223545; OTO: NOTNLM; aheadofprint; SO: J Neurosurg Spine. 2017 Apr 21:1-5. doi: 10.3171/2016.12.SPINE16540.