| Identifier |
charles_bonnet_syndrome_hemianopic_field_lee |
| Title |
Charles Bonnet Syndrome in the Hemianopic Field |
| Creator |
Andrew G. Lee, MD; Anveet Janwadkar |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (AJ) Class of 2022, Baylor College of Medicine, Houston, Texas |
| Subject |
Charles Bonnet Syndrome; Hallucinations; Visual Loss; Neurodegenerative Disorders |
| Description |
Summary: • Charles Bonnet syndrome o Visual formed hallucinations (often of little people) o Other key features > Vision loss > Insight into the unreal nature of the phenomena > No auditory component • If auditory component exists: o Patient awake, alert, and oriented? o Causes can include: > Dementia > Delirium > Drugs > Hallucinogens > Dsm-5 type diagnosis > In elderly, consider primary neurodegenerative disorders (i.e. Lewy body dementia) > No better explanation • Exclude possibility of seizure o Often caused by macular degeneration • Hemianopic form of Charles Bonnet syndrome o Vision loss is hemianopic o Caused by an occipital lobe lesion resulting in right homonymous hemianopsia o Charles Bonnet phenomena only seen in hemianopic field o All other criteria remain the same (insight, no auditory component, no better explanation). |
| Transcript |
So today, we're going to be talking about the Charles Bonnet syndrome, but a special type of the Charles Bonnet syndrome, which is a hemianopic Charles Bonnet. ; And so, Charles Bonnet, of course, didn't actually have the disease. He was describing his grandfather, and what the grandfather saw was formed visual hallucinations. They're often people, and often they're little people - lilliputian figures. And the key features are: they have to have the vision loss, and usually it's severe, but it can be as low as 20/40; they have to have some insight into the unreal nature of the phenomena; they have to have no auditory component, so they can't talk to it, and the person can't talk to them, and if it's not a person, it certainly shouldn't be talking to them. If they are talking, then you really should be thinking about awake, alert, and oriented: dementia, delirium, drugs, hallucinogens, or dsm-5 type diagnosis. In the elderly patient, we're worried about neurodegenerative disorders like Lewy body dementia and other neurocognitive type of symptoms as from primary neurodegenerative disorders. And in addition, they really can't have a better explanation. So, the one I want to focus on today is the vision loss. So even though I just told you usually they have a severe vision loss, there is a form of the Charles Bonnet syndrome, where their vision is 20/20, they have a normal pupil, the rest of the exam is normal. And even though macular degeneration is one of the most common causes of the Charles Bonnet syndrome, you can have a hemianopic form, where they have an occipital lesion, and they have a right homonymous hemianopsia, and they only see the Bonnet phenomenon in the hemianopic field. You need to exclude the possibility that it's seizure - obviously non-organic cannot be completely excluded, But you need to know that the Charles Bonnet syndrome, the vision loss can be hemianopic. All the other criteria remain the same. |
| Date |
2021-04 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6j73dhq |
| Setname |
ehsl_novel_lee |
| ID |
1680592 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6j73dhq |
