Poster 348: An Unusual Cause of Visual Hallucinations: Embolic Occipital Infarct Causing Charles Bonnet Syndrome: A Case Report

PM&R ◽  
2017 ◽  
Vol 9 ◽  
pp. S242-S242
Author(s):  
Araj Sidki ◽  
Jun Zhang ◽  
Nicole Fiorentino
Keyword(s):  
Case Report ◽  
Visual Hallucinations ◽  
Charles Bonnet Syndrome

scholarly journals High-Density EEG in a Charles Bonnet Syndrome Patient during and without Visual Hallucinations: A Case-Report Study

Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1991
Author(s):  
Andrea Piarulli ◽  
Jitka Annen ◽  
Ron Kupers ◽  
Steven Laureys ◽  
Charlotte Martial
Keyword(s):  
Case Report ◽  
Resting State ◽  
High Density ◽  
Alpha Power ◽  
Visual Hallucinations ◽  
Charles Bonnet Syndrome ◽  
Eeg Data ◽  
Signal Diversity ◽  
Signal Complexity ◽  
Cortical Regions

Charles Bonnet syndrome (CBS) is a rare clinical condition characterized by complex visual hallucinations in people with loss of vision. So far, the neurobiological mechanisms underlying the hallucinations remain elusive. This case-report study aims at investigating electrical activity changes in a CBS patient during visual hallucinations, as compared to a resting-state period (without hallucinations). Prior to the EEG, the patient underwent neuropsychological, ophthalmologic, and neurological examinations. Spectral and connectivity, graph analyses and signal diversity were applied to high-density EEG data. Visual hallucinations (as compared to resting-state) were characterized by a significant reduction of power in the frontal areas, paralleled by an increase in the midline posterior regions in delta and theta bands and by an increase of alpha power in the occipital and midline posterior regions. We next observed a reduction of theta connectivity in the frontal and right posterior areas, which at a network level was complemented by a disruption of small-worldness (lower local and global efficiency) and by an increase of network modularity. Finally, we found a higher signal complexity especially when considering the frontal areas in the alpha band. The emergence of hallucinations may stem from these changes in the visual cortex and in core cortical regions encompassing both the default mode and the fronto-parietal attentional networks.

Visual Hallucinations in Elderly People: Early Dementia, Psychosis or Charles Bonnet Syndrome? Review and Case Report

2017 ◽  
Vol 41 (S1) ◽  
pp. S650-S650
Author(s):  
M. García Moreno ◽  
A. De Cos Milas ◽  
B. Poza Cano ◽  
L. Beatobe Carreño
Keyword(s):  
Differential Diagnosis ◽  
Cognitive Impairment ◽  
Case Report ◽  
Psychiatric Illness ◽  
Late Onset ◽  
Medical Condition ◽  
Rare Condition ◽  
Disruptive Behaviour ◽  
Visual Hallucinations ◽  
Charles Bonnet Syndrome

IntroductionCharles Bonnet Syndrome (CBS) is an uncommon disease that involves visual hallucinations in visually impaired individuals, in absence of cognitive impairment or psychiatric illness, although some authors propose CBS as an early maker of dementia.ObjectivesShow the importance of differential diagnosis in individuals with presence of visual hallucinations, with distinction of CBS from others psychiatric or organic disorders such as hypnogogic and hypnopompic hallucinations, epileptic phenomenon, Parkinson disease, dementia, delirum tremens or late-onset psychosis.MethodsLiterature review about visual hallucinations in people with psychiatric illness, dementia or in absence of these status, followed by a case report of a patient who met criteria for CBS.ResultsEighty one-years-old female with no previous psychiatric illness, experience suddenly visual hallucinations (animals, insects) with secondary anxiety, fear and insomnia as well as disruptive behaviour (throw lye to kill the animals) and delusional interpretations of the hallucinations considering them as a divine proof. Clinical exam, neuroimaging tests and SPECT confirmed just a minimal cognitive impairment nor suggestive of dementia. She had personal history of cataracts and macular degeneration, with no other medical condition. Olanzapine was prescribed but it was withdrew because of adverse effects. Later, haloperidol was introduced with well tolerance and symptom's recovery ad integrum.ConclusionsCharles Bonnet syndrome is a rare condition that may sometimes be the beginning of a dementia. Medical evaluation and complementary tests help differential diagnosis in order to reject others psychiatric/somatic disorders. Neuroleptic and anti-epileptic treatment should be useful to control symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

FDG-PET Scanning Shows Distributed Changes in Cortical Activity Associated with Visual Hallucinations in Eye Disease

2019 ◽  
Vol 19 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Lütfü Hanoglu ◽  
Sultan Yildiz ◽  
Tansel Cakir ◽  
Taha Hanoglu ◽  
Burak Yulug
Keyword(s):  
Visual Cortex ◽  
Fdg Pet ◽  
Underlying Mechanism ◽  
Posterior Cingulate Cortex ◽  
Eye Disease ◽  
Visual Hallucinations ◽  
Charles Bonnet Syndrome ◽  
Pet Scanning ◽  
Inferior Parietal Cortex ◽  
Visual Deafferentation

Background and Objective: Charles Bonnet Syndrome (CBS) has been defined as complex visual hallucinations (CVH) due to visual loss. The underlying mechanism of CBS is not clear and the underlying pathophysiology of the visual hallucinations in CBS patients and pure visually impaired patients is still not clear. </P><P> Methods: In our study, we have scanned three patients with eye disease and CBS (VH+) and three patients with eye disease without CBS (VH-) using FDG-PET. Results: Our results showed underactivity in the pons and overactivity in primary right left visual cortex and inferior parietal cortex in VH- patients and underactivity in left Broca, left inf frontal primary visual cortex and anterior and posterior cingulate cortex in VH+ patients relative to the normative 18FFDG PET data that was taken from the database consisting of 50 age-matched healthy adults without neuropsychiatric disorders. Conclusion: From this distributed pattern of activity changes, we conclude that the generation of visual hallucination in CBS is associated with bottom-up and top-down mechanism rather than the generally accepted visual deafferentation-related hyperexcitability theory.

Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment

2020 ◽  
Vol 13 (12) ◽  
pp. e233179
Author(s):  
Eric Garrels ◽  
Fawziya Huq ◽  
Gavin McKay
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Potassium Channel ◽  
Limbic Encephalitis ◽  
Psychiatric Symptoms ◽  
Differential Diagnoses ◽  
Visual Hallucinations ◽  
Voltage Gated ◽  
History Of ◽  
Impaired Cognition

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

scholarly journals An overview of psychological and social factors in Charles Bonnet syndrome

2021 ◽  
Vol 13 ◽  
pp. 251584142110347
Author(s):  
Lee Jones ◽  
Lara Ditzel-Finn ◽  
Jamie Enoch ◽  
Mariya Moosajee
Keyword(s):  
Emotional Response ◽  
Causal Mechanism ◽  
Visual Hallucinations ◽  
Cognitively Normal ◽  
Charles Bonnet Syndrome ◽  
Raising Awareness ◽  
Normal Individuals ◽  
The Social ◽  
Recent Developments ◽  
Insight Into

Charles Bonnet syndrome (CBS) is a condition where cognitively normal individuals with sight impairment experience simple and/or complex visual hallucinations. The exact pathogenesis of CBS is unknown; however, deafferentation is often recognised as a causal mechanism. Studies have provided insight into the multifaceted impact of CBS on wellbeing. Onset of CBS may cause distress among those believing visual hallucinations are indicative of a neurological condition. Hallucinatory content is often congruent with the emotional response. For example, hallucinations of a macabre nature typically result in a fearful response. Visual hallucinations may be highly disruptive, causing everyday tasks to become challenging. Clinical management relies on forewarning and pre-emptive questioning. Yet, knowledge and awareness of CBS is typically low. In this review, we provide a summary of the social and psychological implications of CBS and explore recent developments aimed at raising awareness and improving patient management.

scholarly journals Improvement in refractory psychosis after initiating management for underlying ADHD

2015 ◽  
Vol 84 (S1) ◽  
pp. 6-8
Author(s):  
Michael Blaszak ◽  
Danica Brister ◽  
Jordon Charlebois ◽  
Erica Hoe ◽  
Maggie Siu
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Case Report ◽  
Clinical Practice ◽  
Attention Deficit ◽  
Clinical Case ◽  
Psychotic Symptoms ◽  
Visual Hallucinations ◽  
Hyperactivity Disorder ◽  
Stimulant Medications ◽  
Pathophysiologic Mechanisms

We report on a unique clinical case of psychosis precipitated by Attention Deficit Hyperactivity Disorder (ADHD) and explore its implications for clinical practice as well as our understanding of these conditions. We describe a clinical case of a 46-year-old male presenting with auditory, olfactory, tactile, and visual hallucinations. We reviewed the literature on reported cases in which psychotic symptoms were treated with stimulant medications for ADHD comorbidity. This case report reveals the potential for properly selected patients to benefit from a consideration of ADHD comorbidity and a trial of treatment with that focus. In addition, the literature reveals a pathophysiologic association between psychosis and ADHD supported by neurobiological data. However, far more research is required to fully understand these conditions and their relationship. We conclude that ADHD and psychosis have some related pathophysiologic mechanisms but their connection has not been adequately explored. This case adds support to literature suggesting that in refractory psychosis, clinicians should re-evaluate the diagnosis and one of the considerations should be ADHD. In certain cases, the presence of psychotic symptoms with ADHD should not exclude the use of stimulants.

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