Cerebral polyopia following treatment with chemotherapy for breast cancer.

Abstract

Diplopia / polyopia of cerebral origin is an infrequent encounter in neuro- ophthalmic practice. Its origin is not exactly known, but it is believed to be secondary to bilateral occipital lobe lesions, commonly infarction. Chemotherapy is well documented to cause neuronal damage. Most patients develop manifestations of cognitive and CNS complications during treatment or shortly afterwards. However, delayed CNS damage may also occur; the precise pathophysiology under this is not known. A recent research suggested that chemotherapy causes demyelination of the deep white matter in the cerebrum which may explain the delayed and/ or long term neurological deficit . We report a case of cerebral polyopia in a 56 year old female who was treated with chemotherapy , in addition to radiotherapy and hormonal therapy, seven years before developing polyopia. Her MRI showed degenerative lesions of the deep white matter consistent with demeylination.