Cerebral Polyopia

1. Ade Wijaya, MD – February 2021

2. Definition
“Duplication of images (doublets, triplets, and more) in
the absence of a refractive error, fascicular cranial
nerve disease, orbital pathology, or brainstem disease”
Kesserwani H. A Novel Case of Cerebral Diplopia Secondary to a Posterior Parietal Cortex Ischemic Infarct: Proposal of a Mechanism of Generation of Polyopia Due to Convergence
Insufficiency.

3. Etiology
 Occipital lobe disease due to:
- Trauma
- Ischemia
- Epilepsy
- Migraine
Kesserwani H. A Novel Case of Cerebral Diplopia Secondary to a Posterior Parietal Cortex Ischemic Infarct: Proposal of a Mechanism of Generation of Polyopia Due to Convergence
Insufficiency.

4. Mechanism
 Cortical spreading depression
 Abnormal visual synthesis
 Holonomic brain theory:
- Posterior parietal cortex  frontal eye field 
midbrain and paramedian pontine reticular formation.
leading to convergence insufficiency and subsequent
horizontal diplopia.
Kesserwani H (September 07, 2020) An Analytic Dissection of a Case of Cerebral Diplopia: Is the Human Brain a Holographic Device?. Cureus 12(9): e10292. doi:10.7759/cureus.10292
Kesserwani H: The Zeitraffer phenomenon: a strategic ischemic infarct of the banks of the parieto-occipitalsulcus - a unique case report and a side note on the neuroanatomy of
visual perception. Cureus. 2020,12:e9443.

5. Kesserwani H. A Novel Case of Cerebral Diplopia Secondary to a Posterior Parietal Cortex Ischemic Infarct: Proposal of a Mechanism of Generation of Polyopia Due to Convergence
Insufficiency.

6. Kesserwani H. A Novel Case of Cerebral Diplopia Secondary to a Posterior Parietal Cortex Ischemic Infarct: Proposal of a Mechanism of Generation of Polyopia Due to Convergence
Insufficiency.

7. Kesserwani H. A Novel Case of Cerebral Diplopia Secondary to a Posterior Parietal Cortex Ischemic Infarct: Proposal of a Mechanism of Generation of Polyopia Due to Convergence
Insufficiency.

8. Summary
 Polyopia  Diplopia of cerebral origin
 Etiology: occipital lobe disease
Mechanism:
 Cortical spreading depression
 Abnormal visual synthesis
 Holonomic brain theory:
- Posterior parietal cortex  frontal eye field 
midbrain and paramedian pontine reticular formation