Charles Bonnet Syndrome in the Hemianopic Field

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)