[Visual hallucinations and giant cell arteritis: the Charles Bonnet syndrome]

Area of Science:

• Ophthalmology
• Neurology
• Rheumatology

Background:

• Diagnostic strategies for visual hallucinations are not well-defined.
• Giant cell arteritis diagnosis often assumes disease relapse in affected patients, necessitating prompt corticosteroid treatment.
• Charles Bonnet syndrome is an underrecognized cause of visual hallucinations, particularly in the elderly.

Observation:

• A case of an 87-year-old woman with a two-year history of giant cell arteritis is presented.
• The patient presented with a sudden onset of visual hallucinations.
• The patient met all diagnostic criteria for Charles Bonnet syndrome.

Findings:

• The patient's visual hallucinations were attributed to Charles Bonnet syndrome.
• This case highlights the importance of considering Charles Bonnet syndrome in the differential diagnosis of visual hallucinations in patients with giant cell arteritis.
• Misdiagnosis could lead to unnecessary or inappropriate treatment, such as corticosteroids for presumed giant cell arteritis relapse.

Implications:

• This case underscores the need for a broader differential diagnosis when evaluating visual hallucinations in patients with giant cell arteritis.
• Recognizing Charles Bonnet syndrome can prevent misdiagnosis and ensure appropriate patient management.
• Further research into the overlap and differentiation between these conditions is warranted.