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Complex visual hallucinations in a Parkinson patient: don't blame James if it's Charles's fault

Kurt Segers1

  • 1Neurology Department, Brugmann University Hospital, Van Gehuchtenplein, Brussels, Belgium. kurt.segers@chu-brugmann.be

International Psychogeriatrics
|November 14, 2012
PubMed

Insights

Parkinson's disease patients with severe vision loss may experience visual hallucinations. Charles Bonnet syndrome is a likely cause, treatable with carbamazepine.

Area of Science:

  • Neuroscience
  • Ophthalmology

Background:

  • Parkinson's disease (PD) patients often experience non-motor symptoms, including visual disturbances.
  • Severe visual impairment can lead to complex visual hallucinations.

Observation:

  • A patient with Parkinson's disease and significant bilateral peripheral vision loss presented with persistent daily visual hallucinations.
  • Hallucinations occurred upon waking and lasted for three days, with preserved patient insight.

Findings:

  • The presentation was highly suggestive of Charles Bonnet syndrome (CBS), a condition characterized by visual hallucinations in visually impaired individuals.
  • Carbamazepine treatment was initiated and successfully resolved the hallucinations.

Implications:

  • Physicians should consider Charles Bonnet syndrome as a differential diagnosis for visual hallucinations in Parkinson's disease patients with visual impairment.
  • Early recognition and appropriate treatment, such as carbamazepine, can effectively manage these debilitating hallucinations.

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