When I watch television, I lose my sight
When I watch television, I lose my sight
History
A 68-year-old woman had a 1-year history of recurring stereotypic spells approximately twice monthly. They typically occurred in the evening while she was quietly watching television. She noted gradually worsening blurring of vision in the left eye such that within 15 minutes she had no meaningful vision. At about this time, she also noticed a moderately severe, steady discomfort within and around the left globe which spread to involve the ipsilateral forehead and temporal region, possibly with some associated mild increase in tearing. If she remained sitting upright, two 500-mg acetaminophen tablets would allow her to nap for 30 minutes, by which time her spell would have resolved completely. She avoided lying down, certain that this change in posture would worsen her symptoms. She had a past medical history of well-treated renovascular hypertension.
Examination
The findings on neurologic examination were normal.
Investigations
The erythrocyte sedimentation rate was 33 mm/h (normal, 0-29 mm/h). Magnetic resonance imaging (MRI) showed extensive focal and patchy chronic small-vessel ischemic changes in the perivascular white matter, old left basal ganglia lacunar infarcts, and basilar artery ectasia. The results of magnetic resonance angiography were essentially normal.
A diagnostic study was performed.
What do u think?
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