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Case Reports
. 2022 Feb 26;3(1):23-28.
doi: 10.36518/2689-0216.1303. eCollection 2022.

A Case Report and Review: Charles Bonnet Syndrome Plus With Dementia

Sindhura Kompella  1 , Shivani Kaushal  2 , Sara A Khan  2 , Clara L Alvarez Villalba  1
Affiliations
Case Reports

A Case Report and Review: Charles Bonnet Syndrome Plus With Dementia

Sindhura Kompella et al. HCA Healthc J Med. .

Abstract

Introduction: Charles Bonnet Syndrome (CBS) refers to visual hallucinations in visually impaired patients without psychiatric illness who are typically aware that their hallucinations are not real. Rare cases in the literature describe patients with atypical CBS, or CBS plus, who experience hallucinations in the context of sensory deficits but do not meet all of the criteria of a CBS diagnosis. These cases may include hallucinations in more than one sensory modality, including auditory hallucinations, which are thought to arise by a similar pathophysiology to that of the visual hallucinations in CBS. Unfortunately, the clinical criteria for atypical CBS are ambiguous, potentially explaining the rarity of the diagnosis. In addition, certain features of atypical CBS may make the condition particularly prone to misdiagnosis.

Case presentation: We report a case of atypical CBS in a 67-year-old white male patient presenting with visual and auditory hallucinations that were improved by reassurance. Alongside this case presentation, we provide a review of atypical CBS cases in the literature to compare the diverse features of the syndrome. For this review, we included cases of atypical CBS or CBS plus within the past 20 years for which we could obtain the full text.

Conclusion: Clearer guidelines for the diagnosis of atypical CBS and greater attention to the disorder could substantially improve the management of patients presenting with hallucinations. A broader differential diagnosis including atypical CBS for elderly patients with new-onset hallucinations could help clinicians and patients avoid unnecessary medical workup and treatment.

Keywords: Charles Bonnet Syndrome; Charles Bonnet Syndrome/diagnosis; Charles Bonnet Syndrome/diagnostic imaging; auditory hallucinations; diabetic retinopathy; hallucinations/etiology; hearing loss; perceptual disorders; visual hallucinations.

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Conflict of interest statement

Conflicts of Interest The authors declare they have no conflicts of interest.

Figures

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Figure 1
Non-contrast CT of the head, showing diffuse mild atrophy.
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References

    1. Pang L. Hallucinations experienced by visually impaired: Charles Bonnet syndrome. Optom Vis Sci. 2016;93(12):1466–1478. doi: 10.1097/OPX.0000000000000959. - DOI - PMC - PubMed
    1. Arun P, Jain R, Tripathi V. Atypical Charles Bonnet syndrome. Indian J Psychol Med. 2013;35(4):402–404. doi: 10.4103/0253-7176.122240. - DOI - PMC - PubMed
    1. Koek AY, Espinosa PS. Ave Maria and visions of children: Atypical Charles Bonnet syndrome or two coexisting deafferentation phenomena? Cureus. 2018;10(8):e3191. doi: 10.7759/cureus.3191. - DOI - PMC - PubMed
    1. Van Ranst A, Keereman V, Hemelsoet D, De Herdt V. Sensory deafferentation syndromes: a case of Charles Bonnet and musical ear syndrome. Acta Neurol Belg. 2017;117(3):769–770. doi: 10.1007/s13760-016-0728-9. - DOI - PubMed
    1. Carpenter K, Jolly JK, Bridge H. The elephant in the room: understanding the pathogenesis of Charles Bonnet syndrome. Ophthalmic Physiol Opt. 2019;39(6):414–421. doi: 10.1111/opo.12645. - DOI - PubMed

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