Biomedical subjects
Publications and source records attributed to L Pankow.
A case study of a 100-year-old patient with visual hallucinations and visual impairment is presented. The patient was fit with optical aids in an effort to reduce the hallucinations, operating on the "phantom vision" theory, which postulates that visual hallucinations associated with visual impairment result from the brain's attempt to "fill in" for compromised visual input.
OBJECTIVE: To clarify the neuropsychological function in patients with Charles Bonnet Syndrome. DESIGN: Control group comparison study. SETTING: University of Chicago Hospitals. PARTICIPANTS: The neuropsychological function of 15 older adults with presenting complaints of visual hallucinations who met criteria for Charles Bonnet Syndrome (CBS) were compared with 11 demographically matched controls to determine if there was any evidence of functional brain impairment. CBS patients were screened for focal brain lesions and epileptic disturbance via MRI and EEG and also received pattern visual evoked potentials and ophthalmological examinations. MEASUREMENTS: Scores from the Wechsler Adult Intelligence Scale-Revised, Mattis Dementia Rating Scale, Wechsler Memory Scale, and the Auditory Verbal Learning Test were compared. RESULTS: Significant differences were found between the two groups on the neuropsychological measures. Moreover, 14 of 14 subjects had ocular abnormalities and six of eight had abnormal age-corrected pattern visual evoked potentials indicative of dysfunction in the visual system. CONCLUSIONS: The results of the study indicate that patients diagnosed with Charles Bonnet Syndrome evidence neuropsychological changes commonly associated with the early stages of dementia. Therefore, in patients with impaired vision, the appearance of cognitive deficits, albeit subtle, occur with the onset of visual hallucinations. We propose that isolated visual hallucinations in the older adult may be an indication of the early stages of dementia.
Onset of visual hallucinations in elderly individuals is a widespread problem with an elusive etiology. Many patients with this problem have visual and cognitive deficits. Intervention with optical aids has not been investigated as a means of treating these hallucinations. The authors report 3 cases in which optical aids were evaluated for efficacy in reducing frequency of visual hallucinations in elderly patients with dementia and visual deficits.
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