Metamorphopsia with SMART Syndrome: A Case Report.

Authors :: Flain L
Lay A
Gadil E
James K
Thanancheyan S
Bacchi S
Goh R
Source :: Case reports in neurology [Case Rep Neurol] 2024 Jul 24; Vol. 16 (1), pp. 208-212. Date of Electronic Publication: 2024 Jul 24 (Print Publication: 2024).
Publication Year :: 2024
Abstract: Introduction: SMART syndrome is a rare complication of brain radiotherapy. This is the first described presentation of SMART syndrome with metamorphopsia, which responded to aspirin, verapamil, and high-dose L-arginine therapy.<br />Case Presentation: A 43-year-old man presented with 3 weeks of migraine headaches with metamorphopsia and complex visual hallucinations affecting the left lower quadrant of both visual fields. This occurred on a background of high-dose radiotherapy for right cerebellar astrocytoma 32 years ago. MRI brain demonstrated unilateral gyriform enhancement and FLAIR hyperintense cortical swelling in the right occipital lobe consistent with SMART syndrome.<br />Conclusion: Unusual presentations of SMART syndrome exist and require consideration in all patients with focal neurological deficit post-brain radiotherapy. Validated diagnostic and treatment modalities for SMART syndrome are urgently required.<br />Competing Interests: The authors declare that there is no conflict of interest.<br /> (© 2024 The Author(s). Published by S. Karger AG, Basel.)