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Charles Bonnet syndrome after herpes simplex encephalitis.

Ömer Faruk Aydin1, Hülya Ince, Haydar Ali Taşdemir

  • 1Department of Pediatric Neurology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey. ofaydin@yahoo.com

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|April 12, 2012
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Summary

Charles Bonnet syndrome, a rare cause of visual hallucinations, can affect children. This case highlights visual impairment and optic neuritis in a child, emphasizing the syndrome

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Area of Science:

  • Ophthalmology
  • Neurology
  • Pediatrics

Background:

  • Charles Bonnet syndrome (CBS) is characterized by visual hallucinations in individuals with vision loss, typically in older adults.
  • CBS in childhood is exceptionally rare, with limited case reports in pediatric populations.

Observation:

  • A child developed visual impairment and complex visual hallucinations following herpes encephalitis and acyclovir treatment.
  • The patient presented with bilateral decreased visual acuity, normal funduscopic findings, and transient visual hallucinations.
  • Neuroimaging revealed bilateral optic nerve hyperintensity, suggesting optic neuritis.

Findings:

  • The child experienced visual hallucinations preceding total vision loss, without behavioral or cognitive changes.
  • Magnetic resonance imaging confirmed bilateral optic nerve inflammation (optic neuritis).
  • Corticosteroid treatment led to complete vision recovery within one month.

Implications:

  • This case underscores that Charles Bonnet syndrome, though rare, should be considered in pediatric visual impairment with complex hallucinations.
  • Early recognition and appropriate treatment of associated optic neuritis are crucial for visual recovery in affected children.
  • Further research is needed to understand the pathophysiology and prevalence of CBS in pediatric populations.