Charles Bonnet Syndrome: Case series

Abstract

Since its first description in 1760, Charles Bonnet syndrome (CBS) has been reported in many studies. The main characteristics are visual hallucinations, preserved awareness of unreal visions, and absence of psychotic symptoms. CBS can occur with lesions located anywhere along the central visual pathway, from the eye to the calcarine fissure.ObjectiveTo describe patients with CBS and carry out a review of the literature.MethodsSix patients with visual hallucinations were evaluated in an outpatient memory clinic between 2001 and 2008, and their clinical characteristics recorded.ResultsFour patients were female, and the mean age was 74.5±16.9 years. Three patients had visual loss secondary to eye disease and three due to cerebral lesions. The visions consisted of animals, persons, moving objects, bizarre creatures or colored forms, and were considered disturbing by five patients. Five patients received treatment, and only three reported partial benefit from the therapy. Complete recovery was not seen in any of the subjects.ConclusionsCBS is relatively rare and its recognition is important to avoid misdiagnoses with psychiatric or dementing illnesses.

Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis

“…In ffytche and Howard series 9 , tesellopsia ocurred in 74% and abnormalities of size in 42% of their patients, of whom 58% had micropsia. In Brucki et al 10 series, tesellopsia, micropsia, prosopometamorphopsia and polyopsia were observed.…”

“…Notwithstanding a directed questionnaire, a mean delay in diagnosis of almost 42 months indicates that our patients were younger than the elderly patients described in literature. In another Brazilian case series of CBS, Brucki et al 10 described six patients with a mean age of 74.5 years.…”

“…Current suggestions arise from case reports and case series. Neuroleptics, anticonvulsants, antidepressants and cholinesterase inhibitors have already been tried with favorable results 1,2,10 . Our patients did not require treatment either due to its beningnity or lower frequency.…”

Visual Hallucinations in an Old Patient after Cataract Surgery and Treatment

“…If improvement does not occur, first step should be the management of cause of visual loss if possible. If needed, neuroleptics, anticonvulsants, antidepressants, benzodiazepines and cognitive enhancer agents such as cholinesterase inhibitors can be used [3,8,15,16]. Our patient has also been treated successfully with a neuroleptic agent, 0.5 milligram/day risperidone.…”

“…If patients are not bothered by visual hallucinations, treatment may also not be necessary. Only education and reassurance of the benign nature of the events, improving the quality of life may be enough for the patients [8,15]. Hallucinations may also resolve spontaneously [6].…”