A 70-year-old woman after a large right occipital infarct walks into furniture, bumps into people, and cannot name objects placed in front of her, yet insists her vision is normal and confabulates descriptions of the room. Fundoscopy, pupils, and eye movements are normal. The most likely diagnosis is:
- A Prosopagnosia from a fusiform gyrus lesion
- B Balint syndrome from bilateral parietal infarcts
- C Anton syndrome (cortical blindness with anosognosia) ✓
- D Optic neuropathy with early macular involvement
Correct answer: C. Anton syndrome (cortical blindness with anosognosia)
Explanation
Anton syndrome is bilateral cortical blindness caused by bilateral occipital (posterior cerebral artery) infarction, in which the patient denies blindness and confabulates. The intact anterior visual pathways explain the normal fundus, pupils, and eye movements, and this also explains why the pupillary light reflex is preserved. Balint syndrome involves simultanagnosia, oculomotor apraxia, and optic ataxia without denial of blindness, which distinguishes it from this presentation.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.