Limits...
Three Cases with Visual Hallucinations following Combined Ocular and Occipital Damage.

Paradowski B, Kowalczyk E, Chojdak-Łukasiewicz J, Loster-Niewińska A, Służewska-Niedźwiedź M - Case Rep Med (2013)

Bottom Line: We present the cases of three patients who experienced complex visual hallucinations following various pathomechanisms.In two cases, diagnosis showed coexistence of occipital lobe damage with ocular damage, while in the third case it showed occipital lobe damage with retrobulbar optic neuritis.Theories of pathogenesis and the neuroanatomical basis of complex visual hallucinations are discussed and supported by literature review.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Wroclaw Medical University, Ulica Borowska 213, 50-556 Wrocław, Poland.

ABSTRACT
Charles Bonnet syndrome is an underrecognized disease that involves visual hallucinations in visually impaired patients. We present the cases of three patients who experienced complex visual hallucinations following various pathomechanisms. In two cases, diagnosis showed coexistence of occipital lobe damage with ocular damage, while in the third case it showed occipital lobe damage with retrobulbar optic neuritis. Theories of pathogenesis and the neuroanatomical basis of complex visual hallucinations are discussed and supported by literature review.

No MeSH data available.


Related in: MedlinePlus

MR of the head; T2-weighted images (axial view (a) and sagittal view (b)) demonstrate numerous plaques in white matter distribution.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3860123&req=5

fig6: MR of the head; T2-weighted images (axial view (a) and sagittal view (b)) demonstrate numerous plaques in white matter distribution.

Mentions: A 59-year-old Caucasian female, well known to our clinic, with established diagnosis of multiple sclerosis (MS), presented with a 10-day history of decreased right eye vision acuity. The patient also complained of visual phenomena appearing when she was observing objects with her left eye closed. The patient could see nonexistent patterns that she remembered from a piece of cloth she looked at in one of the shops (Figure 5). The visual sensations were not present when the patient was using her lefteye or both eyes. After a few days they disappeared. Her past medical history additionally consisted of hypothyreosis in the course of Hashimoto's disease, hypertension, gastroesophageal reflux disease, and hormone replacement therapy. An ophthalmologic assessment revealed Snellen visual acuity of 0.1 in the right eye and 0.8-0.9 in the left eye and partial loss of colour vision in the right eye. Her neurological examination demonstrated left-sided central facial palsy, mild right upper limb paresis with hyperactive reflexes in four limbs, and bilateral pyramidal signs. An auxiliary investigation showed bilaterally abnormal visual evoked potential latency (worse in the right eye) and single bursts of theta and sharp waves over the left hemisphere during photic stimulation in electroencephalography. Routine laboratory tests included full blood count, serum electrolytes, and glucose; kidney functions were within the normal range. Magnetic resonance imaging of the brain demonstrated multiple pathological areas consistent with demyelination, including lesions within the course of the optic radiation in the left hemisphere. None of these strengthened after an injection of gadolinium (Figures 6(a) and 6(b)). The patient was diagnosed with a relapse of MS with right-sided optic neuritis.


Three Cases with Visual Hallucinations following Combined Ocular and Occipital Damage.

Paradowski B, Kowalczyk E, Chojdak-Łukasiewicz J, Loster-Niewińska A, Służewska-Niedźwiedź M - Case Rep Med (2013)

MR of the head; T2-weighted images (axial view (a) and sagittal view (b)) demonstrate numerous plaques in white matter distribution.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860123&req=5

fig6: MR of the head; T2-weighted images (axial view (a) and sagittal view (b)) demonstrate numerous plaques in white matter distribution.
Mentions: A 59-year-old Caucasian female, well known to our clinic, with established diagnosis of multiple sclerosis (MS), presented with a 10-day history of decreased right eye vision acuity. The patient also complained of visual phenomena appearing when she was observing objects with her left eye closed. The patient could see nonexistent patterns that she remembered from a piece of cloth she looked at in one of the shops (Figure 5). The visual sensations were not present when the patient was using her lefteye or both eyes. After a few days they disappeared. Her past medical history additionally consisted of hypothyreosis in the course of Hashimoto's disease, hypertension, gastroesophageal reflux disease, and hormone replacement therapy. An ophthalmologic assessment revealed Snellen visual acuity of 0.1 in the right eye and 0.8-0.9 in the left eye and partial loss of colour vision in the right eye. Her neurological examination demonstrated left-sided central facial palsy, mild right upper limb paresis with hyperactive reflexes in four limbs, and bilateral pyramidal signs. An auxiliary investigation showed bilaterally abnormal visual evoked potential latency (worse in the right eye) and single bursts of theta and sharp waves over the left hemisphere during photic stimulation in electroencephalography. Routine laboratory tests included full blood count, serum electrolytes, and glucose; kidney functions were within the normal range. Magnetic resonance imaging of the brain demonstrated multiple pathological areas consistent with demyelination, including lesions within the course of the optic radiation in the left hemisphere. None of these strengthened after an injection of gadolinium (Figures 6(a) and 6(b)). The patient was diagnosed with a relapse of MS with right-sided optic neuritis.

Bottom Line: We present the cases of three patients who experienced complex visual hallucinations following various pathomechanisms.In two cases, diagnosis showed coexistence of occipital lobe damage with ocular damage, while in the third case it showed occipital lobe damage with retrobulbar optic neuritis.Theories of pathogenesis and the neuroanatomical basis of complex visual hallucinations are discussed and supported by literature review.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Wroclaw Medical University, Ulica Borowska 213, 50-556 Wrocław, Poland.

ABSTRACT
Charles Bonnet syndrome is an underrecognized disease that involves visual hallucinations in visually impaired patients. We present the cases of three patients who experienced complex visual hallucinations following various pathomechanisms. In two cases, diagnosis showed coexistence of occipital lobe damage with ocular damage, while in the third case it showed occipital lobe damage with retrobulbar optic neuritis. Theories of pathogenesis and the neuroanatomical basis of complex visual hallucinations are discussed and supported by literature review.

No MeSH data available.


Related in: MedlinePlus