Anton’s syndrome: a rare and unusual form of blindness

What is it about?

Anton Babinski syndrome is characterized by blindness, without the self-awareness of blindness. The anterior visual tracts are intact and lesion is located in the posterior cerebral cortex, located in the occipital lobe. Patients is in complete denial of visual loss. Confabulation forms a major part of the syndrome. In a bookish picture of Anton syndrome, area of damage is confined to occipital lobes only, but in practice, parts of the brain, either in close proximity to occipital lobe, or those which share a common blood supply, are also involved. This results in a wide array of symptomatology ranging from but not limited to, cognitive impairment with temporal lobe involvement or somnolence and drowsiness due damage to bilateral thalami. This may complicate an already difficult neurological examination. Loss of vision has a major impact on rehabilitation after a stroke. Lack of insight of blindness also poses an increased risk of fall. 
We describe four cases of Anton’s syndrome. Based on the extent of damage to cerebral tissue, these patients present with a spectrum of neurological deficits, in addition to Anton’s Syndrome. First case is that of a 73-year-old lady, who presented with two separate events of intraparenchymal brain haemorrhage, four years apart. Her first stroke affected the left and second affected the right occipital lobe. Damage to both lobes resulted in cortical blindness. Second case is an 88-year-old gentleman, who suffered from two ischemic strokes, two days apart, both in territory of posterior cerebral arteries. This resulted in bilateral occipital and temporal lobe infarcts. Third case is a 64-year-old female who suffered bilateral occipital lobe infarction post hemodialysis. Last case is that of an 80-year-old lady who presented after a collapse. Imaging confirmed basilar artery thrombosis, causing bilateral thalamic, temporal and occipital lobe infarction, resulting in cortical blindness, along with quadriparesis.

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