Charles Bonnet syndrome in hemianopia, following antero-mesial temporal lobectomy for drug-resistant epilepsy.
Charles Bonnet syndrome (CBS) is a disorder characterized by the occurrence of complex visual hallucinations in patients with acquired impairment of vision and without psychiatric disorders. In spite of the high incidence of visual field defects following antero-mesial temporal lobectomy for refractory temporal lobe epilepsy, reports of CBS in patients who underwent this surgical procedure are surprisingly rare. We describe a patient operated on for drug-resistant epilepsy. As a result of left antero-mesial temporal resection, she presented right homonymous hemianopia. A few days after surgery, she started complaining of visual hallucinations, such as static or moving "Lilliputian" human figures, or countryside scenes, restricted to the hemianopic field. The patient was fully aware of their fictitious nature. These disturbances disappeared progressively over a few weeks. The incidence of CBS associated with visual field defects following epilepsy surgery might be underestimated. Patients with post-surgical CBS should be reassured that it is not an epileptic phenomenon, and that it has a benign, self-limiting, course which does not usually require treatment.
Contardi
Sara
S
Neurology Unit, Department of Neurosciences, Bellaria Hospital, Bologna, Italy.
Rubboli
Guido
G
Giulioni
Marco
M
Michelucci
Roberto
R
Pizza
Fabio
F
Gardella
Elena
E
Pinardi
Federica
F
Bartolomei
Ilaria
I
Tassinari
Carlo Alberto
CA
D000927:Anticonvulsants / Q000627:therapeutic use; D003690:Deja Vu / Q000523:psychology; D004351:Drug Resistance; D004569:Electroencephalography; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006212:Hallucinations / Q000209:etiology* / Q000523:psychology; D006392:Hemangioma, Cavernous / Q000150:complications / Q000473:pathology; D006423:Hemianopsia / Q000150:complications / Q000523:psychology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000523:psychology*; D013577:Syndrome; D013702:Temporal Lobe / Q000601:surgery*; D014794:Visual Fields / Q000502:physiology
D000927:Anticonvulsants