Hallucinations Experienced by Visually Impaired: Charles Bonnet Syndrome

Pang, Linda

doi:10.1097/opx.0000000000000959

Cited by 113 publications

(140 citation statements)

References 56 publications

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“…CBS patients are a homogeneous group in two respects. Firstly, they are invariably visually impaired; CBS has been reported in association with a huge variety of conditions causing visual loss . Studies of patients referred to low vision units and ophthalmology clinics estimate a prevalence in the range of 10%–15% of visually impaired older adults .…”

Section: Introductionmentioning

confidence: 99%

The elephant in the room: understanding the pathogenesis of Charles Bonnet syndrome

Carpenter

Jolly

Bridge

2019

Ophthalmic Physiologic Optic

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Purpose Charles Bonnet syndrome (CBS) is a syndrome characterised by complex visual hallucinations in individuals who are cognitively normal, though often elderly and visually impaired. Although first described over 250 years ago, the condition remains poorly understood and difficult to treat. Recent findings Our understanding of CBS pathogenesis has advanced little since it was first described, and much of the recent literature consists of case studies strikingly similar to the first published account of CBS. However, imaging studies have provided some indication as to the cortical areas implicated in the genesis of complex visual hallucinations, and the existence of similar hallucinatory syndromes in other sensory modalities suggests a common underlying mechanism. Summary This review begins by describing what is currently known about CBS, focusing on epidemiology, clinical presentation and diagnosis. It then explores potential starting points for better understanding the pathogenesis of CBS, namely the existence of similar conditions in other sensory modalities and the reproduction of complex visual hallucinations in sensory deprivation scenarios. Finally, it discusses how CBS should be approached in clinical practice.

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Section: Introductionmentioning

confidence: 99%

The elephant in the room: understanding the pathogenesis of Charles Bonnet syndrome

Carpenter

Jolly

Bridge

2019

Ophthalmic Physiologic Optic

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“…In the Charles Bonnet syndrome, several theoretical models have proposed that lesions to specific neural substrates account for hallucinations [3, 4], not surprisingly as hallucinations in this syndrome are believed to be the consequence of disruption of the visual processing pathway. Prior research in the Charles Bonnet syndrome has demonstrated activation of visual cortical areas during visual hallucinations, of auditory and motor language areas during auditory-verbal hallucinations, and of somatosensory areas during somatic hallucinations.…”

Section: Introductionmentioning

confidence: 99%

Clinical and neurocognitive aspects of hallucinations in Alzheimer’s disease

Haj

Roche

Jardri

et al. 2017

Neuroscience & Biobehavioral Reviews

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Due to their prevalence, hallucinations are considered as one of the most frequent psychotic symptom in Alzheimer’s disease (AD). These psychotic manifestations reduce patients’ well-being, increase the burden of caregivers, contribute to early institutionalization, and are found to be related with the course of cognitive decline in AD. Considering their consequences, we provide a comprehensive account of the current state of knowledge about the prevalence and characteristics of hallucinations in AD. We provide a comprehensive and testable theoretical model about hallucinations in AD: the ALZHA (ALZheimer and HAllucinations) model. In this model, neurological, genetic, cognitive, affective, and iatrogenic factors associated with hallucinations in AD are highlighted. According to this model, hallucinations in AD first involve trait markers (i.e., cognitive deficits, neurological deficits, genetic predisposition and/or sensory deficits) to which state markers that may specifically trigger these experiences are added (e.g., psychological distress and/or iatrogenic factors). Finally, we provide recommendations for assessment and management of these psychotic manifestations in AD, with the aim to both serve patients, caregivers, and health professionals.

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“…Pharmacological treatment of CBS is usually initiated when reassurance fails and/or the patients are in severe distress . Although there is no specific recommended pharmacological treatment guideline, several agents including antipsychotics, anticonvulsants, anti‐anxiety, and selective serotonin inhibitors are widely used for the treatment of CBS with variable results . The evidence is limited to support the effectiveness of valproate monotherapy in the treatment of psychosis, and it is typically used as an adjuvant particularly for the symptoms of aggression, excitement, and tardive dyskinesia .…”

Section: Discussionmentioning

confidence: 99%

Complex visual hallucinatory experience in an elderly blind woman with glaucoma: revisiting Charles Bonnet syndrome

Nyundo

Mwombeki

2018

Clinical Case Reports

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Key Clinical MessageFor fear of being ridiculed, individuals with visual hallucinations hide their experiences and thus remain unrecognized and miss treatment. An elderly blind woman secondary to glaucoma experienced visual hallucinations accompanied by gross behavior disturbances. She improved with sodium valproate after haloperidol failed and remained relatively improved upon 3 months follow‐up.

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Hallucinations Experienced by Visually Impaired: Charles Bonnet Syndrome

Abstract: Supplemental digital content is available in the text.

Cited by 113 publications

References 56 publications

The elephant in the room: understanding the pathogenesis of Charles Bonnet syndrome

The elephant in the room: understanding the pathogenesis of Charles Bonnet syndrome

Clinical and neurocognitive aspects of hallucinations in Alzheimer’s disease

Complex visual hallucinatory experience in an elderly blind woman with glaucoma: revisiting Charles Bonnet syndrome

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