Charles Bonnet syndrome, as a manifestation of lesions with different localization - clinical cases
Keywords:
acute ischemic stroke, visual acuity, optic tract, visual hallucinations, Charles Bonnet syndromeAbstract
Charles Bonnet syndrome is a neurological syndrome in which conscious visual hallucinations result from impaired vision. Hallucinations can be simple patterns or detailed images of events, people, or places. They are visual only and do not involve auditory or other sensory modalities. People with Charles Bonnet syndrome usually know that the visions are unreal. In the etiopathogenesis of the disease, damage can lie both in the front part (more often in eye diseases) and in the back part of the visual pathways (for example, in stroke or tumor). Now, the syndrome is not completely curable, but various approaches and medications are used to reduce the frequency and duration of visual hallucinations.
Clinical cases: We present two clinical cases of patients with Charles Bonnet syndrome but with different etiologies of the syndrome. In the first clinical case, the patient developed visual hallucinations after long-term progressive and severe ophthalmological disease. The second clinical case presents a patient suffering from Charles Bonnet syndrome after experiencing an ischemic stroke.
Conclusion: Charles Bonnet syndrome is a relatively rare neurological-psychiatric symptom complex, which should, however, be considered in patients suffering from impaired vision and conscious visual hallucinations.
References
Abbott EJ, Connor GB, Artes PH, et al. Visual loss and visual hallucinations in patients with age-related macular degeneration (Charles Bonnet Syndrome). Invest Ophthalmol Vis Sci 2007;48:1416–23
Adamczyk DT. Visual phenomena, disturbances, and hallucinations. Optom Clin 1996;5:33–52.
Alao AO, Hanrahan B. Charles Bonnet Syndrome: visual hallucination and multiple sclerosis. Int J Psychiatry Med 2003;33:195–9.
Cogan DG. Visual hallucinations as release phenomena. Graefes Arch Clin Exp Ophthalmol 1973;188:139–50.
Cox TM, Ffytche DH. Negative outcome Charles Bonnet syndrome. Br J Ophthalmol 2014;98:1236–9.
Crane WG, Fletcher DC. Prevalence of photopsias and Charles-Bonnet Syndrome in a low vision population. Invest Ophth Vis Sci 1993;34(Suppl.):790.
El Haj M, Roche J, Jardri R, et al. Clinical and neurocognitive aspects of hallucinations in Alzheimer's disease. Neurosci Biobehav Rev. 2017 Dec;83:713-720.
Essali N, Miller BJ. Psychosis as an adverse effect of antibiotics. Brain Behav Immun Health. 2020 Dec;9:100148.
Ffytche DH, Howard RJ, Brammer MJ, et al. The anatomy of conscious vision: an fMRI study of visual hallucinations. Nat Neurosci 1998;1:738–42.
Ffytche DH. Visual hallucinatory syndromes: past, present, and future. Dialogues Clin Neurosci 2007;9:173–89.
Gilmour G, Schreiber C, Ewing C. An examination of the relationship between low vision and Charles Bonnet Syndrome. Can J Ophthalmol2009;44:49–52.
Goldner JA. Metoprolol-induced visual hallucinations: a case series. J Med Case Rep. 2012 Feb 15;6:65.
Higdon E, Twilla JD, Sands C. Moxifloxacin-Induced Visual Hallucinations: A Case Report and Review of the Literature. J Pharm Pract. 2017 Jun;30(3):375-377.
Jan T, Del Castillo J. Visual hallucinations: charles bonnet syndrome. West J Emerg Med. 2012 Dec;13(6):544-7.
Kazui H, Ishii R, Yoshida T, et al. Neuroimaging studies in patients with Charles Bonnet Syndrome. Psychogeriatrics 2009;9:77–84.
Kester EM. Charles Bonnet syndrome: case presentation and literature review. Optometry 2009;80:360–6.
Khan JC, Shahid H, Thurlby DA, et al. Charles Bonnet Syndrome in age-related macular degeneration: the nature and frequency of images in subjects with end-stage disease. Ophthalmic Epidemiol 2008;15:202–8.
Komeima K, Kameyama T, Miyake Y. Charles Bonnet Syndrome associated with a first attack of multiple sclerosis. Jpn J Ophthalmol 2005;49:533–4.
Lang UE, Stogowski D, Schulze D, et al. Charles Bonnet Syndrome: successful treatment of visual hallucinations due to vision loss with selective serotonin reuptake inhibitors. J Psychopharmacol 2007;21:553–5.
Lepore FE. Spontaneous visual phenomena with visual loss: 104 patients with lesions of retinal and neural afferent pathways. Neurology. 1990 Mar;40(3 Pt 1):444-7.
Madill SA, Ffytche DH. Charles Bonnet Syndrome in patients with glaucoma and good acuity. Br J Ophthalmol2005:785–6.
Manford M, Andermann F. Complex visual hallucinations. Clinical and neurobiological insights. Brain 1998;121(Pt. 10):1819–40.
Menon GJ. Complex visual hallucinations in the visually impaired: a structured history-taking approach. Arch Ophthalmol2005;123:349–55.
Merabet LB, Maguire D, Warde A, et al. Visual hallucinations during prolonged blindfolding in sighted subjects. J Neuroophthalmol 2004;24:109–13.
Mocellin R, Walterfang M, Velakoulis D. Neuropsychiatry of complex visual hallucinations. Aust N Z J Psychiatry2006;40:742–51.
Moja MC, Milano E, Gasverde S, et al. Olanzapine therapy in hallucinatory visions related to Bonnet Syndrome. Neurol Sci2005;26:168–70.
Pang L. Hallucinations Experienced by Visually Impaired: Charles Bonnet Syndrome. Optom Vis Sci. 2016 Dec;93(12):1466-1478.
Pliskin NH, Kiolbasa TA, et al. Charles Bonnet Syndrome: an early marker for dementia? J Am Geriatr Soc 1996;44:1055–61
Santhouse AM, Howard RJ, Ffytche DH. Visual hallucinatory syndromes and the anatomy of the visual brain. Brain 2000;123:2055–64.
Schwartz TL, Vahgei L. Charles Bonnet Syndrome in children. J AAPOS1998;2:310–3.
Shufman NE, Witztum E, Vass A. Harefuah. Ephedrine psychosis. 1994 Sep;127(5-6):166-8, 215.
Siatkowski RM, Zimmer B, Rosenberg PR. The Charles Bonnet syndrome. Visual perceptive dysfunction in sensory deprivation. J Clin Neuroophthalmol. 1990 Sep;10(3):215-8.
Teunisse RJ, Cruysberg JR, Hoefnagels WH, et al. Visual hallucinations in psychologically normal people: Charles Bonnet's syndrome. Lancet. 1996 Mar 23;347(9004):794-7.
Vale TC, Fernandes LC, Caramelli P. Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis. Arq Neuropsiquiatr 2014;72:333–6
Vaphiades MS, Celesia GG, Brigell MG. Positive spontaneous visual phenomena limited to the hemianopic field in lesions of central visual pathways. Neurology. 1996 Aug;47(2):408-17.
Vukicevic M, Fitzmaurice K. Butterflies and black lacy patterns: the prevalence and characteristics of Charles Bonnet hallucinations in an Australian population. Clin Experiment Ophthalmol 2008;36:659–65.
Wilkinson F. Auras and other hallucinations: windows on the visual brain. Prog Brain Res 2004;144:305–20.
Yacoub R, Ferrucci S. Charles Bonnet Syndrome. Optometry 2011;82:421–7.
Downloads
Published
How to Cite
Issue
Section
ARK
License
Copyright (c) 2024 Bulgarian Neurology

This work is licensed under a Creative Commons Attribution 4.0 International License.