J Korean Ophthalmol Soc.  2008 Mar;49(3):539-542. 10.3341/jkos.2008.49.3.539.

A Case of Charles Bonnet Syndrome After Resection of a Meningioma

• Han SB
• Hwang JM

• KMID: 2211332
• DOI: http://doi.org/10.3341/jkos.2008.49.3.539

Abstract

PURPOSE: To report a case of Charles Bonnet syndrome that developed after resection of a meningioma.
CASE SUMMARY
The authors reviewed the medical record, brain magnetic resonance image, and Goldmann visual field test of a 56-year-old male patient who was diagnosed with a meningioma in the right parietal and occipital lobe and underwent resection of the tumor. The preoperative Goldmann visual field test showed homonymous left inferior quadrantanopsia. Subtotal resection of the mass in the right parietal and occipital lobe was performed, and postoperative histopathologic examination confirmed the diagnosis of a meningioma. Postoperatively, the patient complained of visual hallucination in an area of the eye with visual field defects. However, his consciousness and orientations were intact, and other cognitive functions were also normal.
CONCLUSIONS
Visual hallucination can manifest in an area with visual field defects after resection of abrain tumor. In such a case, a diagnosis of Charles Bonnet syndrome should be considered.

Keyword

Brain tumor; Charles bonnet syndrome; Meningioma; Visual field defect; Visual hallucination

MeSH Terms

Brain
Brain Neoplasms
Consciousness
Eye
Hallucinations
Hemianopsia
Humans
Magnetic Resonance Spectroscopy
Male
Medical Records
Meningioma
Middle Aged
Occipital Lobe
Orientation
Visual Field Tests
Visual Fields

Figure

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  Figure. 1. Brain magnetic resonance imaging (A=T1 axial; B=T1 coronal; C=T1 sagittal) showed a large heterogenous mass in the right parietal and occipital lobes.

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  Figure. 2. Postoperative Goldmann visual field test showed left inferior homonymous quadrantanopsia (L=left; R=right).

Reference

References

1. Menon GJ, Rahman I, Menon SJ, Dutton GN. Complex visual hallucinations in the visually impaired: the Charles Bonnet syndrome. Surv Ophthalmol. 2003; 48:58–72.

2. Rovner BW. The Charles Bonnet syndrome: a review of recent research. Curr Opin Ophthalmol. 2006; 17:275–7.

3. Dodd J, Heffeman A, Blake J. Visual hallucinations associated with Charles Bonnet Syndrome-an ever increasing diagnosis. Ir Med J. 1999; 92:344–5.

4. Choi EJ, Lee JK, Kang JK, Lee SA. Complex visual hallucinations after occipital cortical resection in a patient with epilepsy due to cortical dysplasia. Arch Neurol. 2005; 62:481–4.

5. Lee JS, Kim SY. A Case of Charles Bonnet Syndrome Following Cerebral Infarction in the Right Occipital Lobe. J Korean Neurol Assoc. 2006; 24:577–80.

6. Damas-Mora J, Skelton-Robinson M, Jenner FA. The Charles Bonnet syndrome in perspective. Psychol Med. 1982; 12:251–61.

7. Gold K, Rabins PV. Isolated visual hallucinations and the Charles Bonnet syndrome: a review of the literature and presentation of six cases. Compr Psychiatry. 1989; 30:90–8.

8. Beniczky S, Keri S, Voros E, et al. Complex hallucinations following occipital lobe damage. Eur J Neurol. 2002; 9:175–6.

9. Chen CS, Lin SF, Chong MY. Charles Bonnet syndrome and multiple sclerosis. Am J Psychiatry. 2001; 158:1158–9.

10. Mewasingh LD, Kornreich C, Christiaens F, et al. Pediatric phantom vision (Charles Bonnet) syndrome. Pediatr Neurol. 2002; 26:143–5.

11. Siatkowski RM, Zimmer B, Rosenberg PR. The Charles Bonnet syndrome: visual perceptive dysfunction in sensory deprivation. J Clin Neuroophthalmol. 1990; 10:215–8.

12. Manford M, Andermann F. Complex visual hallucinations. Clinical and neurobiological insights. Brain. 1998; 121:1819–40.

13. Takata K, Inoue Y, Hazama H, Fukuma E. Night– time hypnopompic visual hallucinations related to REM sleep disorder. Psychiatry Clin Neurosci. 1998; 52:207–9.

14. Poggel DA, Muller– Oehring EM, Gothe J, et al. Visual hallucinations during spontaneous and training– induced visual field recovery. Neuropsychologia. 2007; 45:2598–607.

15. Teunisse RJ, Cruysberg JR, Hoefnagels WH, et al. Visual hallucinations in psychologically normal people: Charles Bonnet syndrome. Lancet. 1996; 347:794–7.

16. Tan CS, Lim VS, Ho DY, et al. Charles Bonnet syndrome in Asian patients in a tertiary ophthalmic center. Br J Ophthalmol. 2004; 88:1325–9.