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Dysmetropsia is a disorder of visual perception characterised by an apparent modification of the size of perceived objects.1–3 Objects can appear larger (macropsia) or smaller (micropsia) than their actual size. Dysmetropsia can result from retinal oedema causing a dislocation of the receptor cells and from lesions affecting other parts of extracerebral visual pathways. Transient micropsia can also result from epileptic seizure, migraine, infectious mononucleosis, the action of mescaline and other hallucinogenic drugs, and psychopathological phenomena.
Permanent dysmetropsia following focal cerebral lesions is rare. Most of the prior reports described hemimicropsia due to lesions mainly involving the lateral aspect of the visual association cortex.1–3 However, reports of hemimacropsia following focal cerebral lesions have been extremely rare1,4 and hemimacropsia following a focal vascular lesion has not been described previously. We describe a patient with left hemimacropsia due to right medial temporo-occipital infarction.
A 64-year-old right-handed man with hypertension was admitted 4 days after a sudden onset of visual disturbance. He …