Transient ictal cortical blindness during middle age. A case report and review of the literature.

We report a case of transient ictal cortical blindness in a 63-year-old woman. We reviewed the literature of all seizure-induced bilateral blindness. After careful evaluation of 44 cases, it was evident that the cases could be categorized into three groups with different etiologies, duration of blindness, and probable visual prognosis. Transient cortical blindness may occur with unilateral focal seizure or with bilateral seizure activity of the primary generalized type. Seizure-induced blindness may be ictal or postictal (Todd's) phenomenon or a permanent consequence following status epilepticus. Its duration varies between less than 1 minute to 4 months, or can be permanent. Our case of cortical blindness is related to new onset occipital epilepsy from a left occipital focus, and adds to the evidence that cortical blindness occasionally occurs as an uncommon manifestation of seizure.