Posterior Cortical Atrophy

Posterior cortical atrophy (PCA), also called Benson's syndrome, is a form of dementia which is usually considered an atypical variant of Alzheimer's disease. The disease causes atrophy of the back (posterior) part of the cerebral cortex, resulting in the progressive disruption of complex visual processing. The disease causes atrophy of the back (posterior) part of the cerebral cortex, resulting in the progressive disruption of complex visual processing.

Although no cure for posterior cortical atrophy exists, several medications as well as many non-pharmaceutical approaches can potentially improve daily functioning and quality of life. Patients with posterior cortical atrophy can often benefit from physical and occupational therapy. Cholinesterase inhibitors approved for Alzheimer's disease, like donepezil (Aricept®), rivastigmine (Exelon®) and galantamine (Razadyne®/Reminyl®), can help the symptoms of PCA by boosting the function of brain cells to compensate for damage caused by Alzheimer's disease. Patients experiencing depression, irritability, frustration and a loss of self-confidence may benefit from antidepressant medication.

We report a case of Benson's Syndrome, a form of occipital Alzheimer's disease, with posterior cortical atrophy on magnetic resonance imaging, in a 62-year-old male, who presented with visual problems, ascribed to the eyes, and had even undergone cataract/intraocular lens surgery in the right eye; and change of glasses 21 times over the past 2 years, with no apparent benefit. This case is of interest both on account of its rarity, and to highlight its features since the diagnosis may be missed in an ophthalmological setting where such patient may go for first consult.