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Presentation type	E-poster
Title	Illusory palinopsia as the presenting symptom of occipital stroke

Purpose	Palinopsia is the persistence or recurrence of visual images after the stimulus has been removed. It has been associated with a wide variety of etiologies such as drugs (illicit or prescription) and migraine, but also head trauma, seizures and structural brain lesions. We report a patient with illusory palinopsia in whom cerebral imaging revealed ischemic occipital stroke.
Methods	Case Report.
Results	An 88-year-old man presented with a month-long history of what he described as “afterimages”: a few seconds after seeing a brightly coloured object, he observed a general blurry non-translucent shape that vaguely resembled a piece of the object. This was preceded by the appearance of coils of white, slowly moving smoke and geometrical shapes arranged in a three by three grid. He also reported visual trailing with lights in motion. The patient had no spontaneous complaint of visual field alterations, but after automated visual field testing revealed a partial left inferior homonymous quadrantanopia, he confirmed that all above symptoms occurred in the left inferior part of his visual field, irrespective of the place in the visual field of the original stimulus. His medical history included paroxysmal atrial fibrillation. However, treatment with apixaban had been stopped by the patient himself because of recurrent ecchymosis. Cerebral MRI confirmed an ischemic lesion at the right calcarine cortex.
Conclusion	Palinopsia is an unusual symptom but may be the presenting manifestation of a posterior visual pathway lesion. The latter has typically been associated with hallucinatory palinopsia, but can also more rarely occur in patients with the illusory subtype as in our case.
Conflict of interest	No

Authors 1

Initials	E
Last name	Smoos
Department	CHU St-Pierre, Ophthalmology
City	Brussels

Authors 2

Initials	S
Last name	Kampouridis
Department	CHU St-Pierre, Radiology
City	Brussels

Authors 3

Initials	T
Last name	Buelens
Department	CHU St-Pierre, Ophthalmology
City	Brussels