Unusual spontaneous and training induced visual field recovery in a patient with a gunshot lesion
- aInstitute of Medical Psychology, Otto-von-Guericke University, Leipziger Strasse 44, 39120 Magdeburg, Germany, bDepartment of Neurology, Charité, Humboldt University, Schumannstrasse 20–21, 10117 Berlin, Germany
- Dr B A Sabel{at}medizin.uni-magdeburg.de
- Received 13 March 2000
- Revised 29 September 2000
- Accepted 11 October 2000
Abstract
Over a period of more than 3 years, changes in visual and neuropsychological functions were examined in a patient with a visual field defect caused by a cerebral gunshot lesion. Initially, the patient had been completely blind, but after 6 months of spontaneous recovery, he showed a homonymous bilateral lower quadrantanopia and impairment of higher visual functions. Unexpectedly, recovery still continued after the first 6 months. This process was documented in detail by visual field examinations using high resolution perimetry. When visual field size had stabilised almost 16 months after the lesion, further improvement could be achieved by visual restitution training. The duration and extent of spontaneous recovery were unusual. In spontaneous as well as in training induced recovery, progress was mainly seen in partially defective areas (areas of residual vision) along the visual field border. Thus, it is speculated that modulation of perceptual thresholds in transition zones of visual field defects contributes to spontaneous and training induced recovery.
