Palinopsia After Splenium Infarction

Clinical Correspondence Section Editors: Robert Avery, DO Karl C. Golnik, MD Caroline Froment, MD, PhD An-Guor Wang, MD Palinopsia After Splenium Infarction Ungsoo Samuel. Kim, MD, PhD A 56-year-old man complained of distortion in the right visual field and strange visual symptoms. The patient noted an unusual phenomenon when looking at people moving their eyes. When he looked at the conjunctiva of the moving eye to an eccentric position, the image of the conjunctiva persisted, and he had a momentary overlapping perception of the con- FIG. 1. A. The drawing of the patient showed the right side blurring with an afterimage. B. There is no definite visual field defect. FIG. 2. MRI showed focal infarction of the left posterior splenium (arrow) (A; Apparent diffusion coefficient (ADC) and B; Diffusion weighted image (DWI)). Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul; and Department of Ophthalmology, Chung-Ang University Gwangmyeong Hospital, Gwangmeyong-si, Republic of Korea. The author reports no conflicts of interest. Address correspondence to Ungsoo S. Kim, MD, PhD, Gwangmyeong Hospital, Deokan-ro 110, Gwangmyeong-si, Gyeonggi-do 14353, Republic of Korea; E-mail: [e-mail] Kim: J Neuro-Ophthalmol 2024; 44: e263-e264 junctiva on the cornea. This visual symptom lasted for several seconds. In other words, it is a symptom that the old image does not disappear and covers the new image (Fig. 1A). However, the visual field test showed normal findings (Fig. 1B). MRI showed infarction of the left posterior part of the splenium (Fig. 2). The patient was diagnosed with palinopsia caused by the infarction of the splenium. e263 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Clinical Correspondence Palinopsia is defined as the persistence or recurrence of a previous visual image (1). Palinopsia could be related to systemic disorders, migraine, central nervous system diseases, and various medications such as topiramate, marijuana, or lysergic acid diethylamide (2). Brain lesions, especially the visual cortex area, can cause palinopsia (3). Function of the splenium needs to be clarified, and it may contribute to the isolation of a figure from the background by detecting its borders (4). In addition, splenium involves the feedback mechanism of the primary visual cortex (5), and it is a large commissural pathway that provides bihemispheric visual information exchange. The lesions in the splenium can disconnect between the occipital cortices. There has been no report the palinopsia after splenium e264 infarction. On a functional basis of splenium, the infarction of splenium could affect the visual process and develop palinopsia. REFERENCES 1. Lahiri D. Palinopsia. Cortex. 2020;133:399. 2. Yun SH, Lavin PJ, Schatz MP, Lesser RL. Topiramate-induced palinopsia: a case series and review of the literature. J Neuroophthalmol. 2015;35:148–151. 3. Meadows JC, Munro SS. Palinopsia. J Neurol Neurosurg Psychiatry. 1977;40:5–8. 4. Knyazeva MG. Splenium of corpus callosum: patterns of interhemispheric interaction in children and adults. Neural Plasticity. 2013;2013:639430. 5. Angelucci A, Bullier J. Reaching beyond the classical receptive field of V1 neurons: horizontal or feedback axons? J Physiol Paris. 2003;97:141–154. Kim: J Neuro-Ophthalmol 2024; 44: e263-e264 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited.