title: Hypermetabolism in the left thalamus and right inferior temporal area on positron emission tomography-statistical parametric mapping (PET-SPM) in a patient with Charles Bonnet syndrome resolving after treatment with valproic acid.
abstract: Charles Bonnet syndrome (CBS) is characterized by the occurrence of complex visual hallucinations in visually impaired patients who understand that what they see is unreal. The pathophysiologic mechanism of CBS is poorly understood. However, hypermetabolism of the thalamocortical pathway as a result of deafferentation was recently proposed as a possible mechanism. A 69-year-old patient with CBS presented with a 5-year history of visual hallucinations after bilateral visual impairment, which had progressed to troublesome images of many unreal people and animals. Positron emission tomography-statistical parametric mapping (PET-SPM) imaging studies initially revealed hypermetabolism in the right inferior temporal area and left thalamus, which disappeared after treatment with valproic acid. This case, using PET-SPM analysis, supports the thalamic hypermetabolism theory of CBS.
authors.affiliation: Department of Neurology, Chung-Ang University Medical Center, Seoul, Republic of Korea.
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Jang
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Youn
authors.forename: Ju-Won
authors.initials: JW
authors.lastname: Seok
authors.forename: Sam-Yeol
authors.initials: SY
authors.lastname: Ha
authors.forename: Hae-Won
authors.initials: HW
authors.lastname: Shin
authors.forename: Suk-Won
authors.initials: SW
authors.lastname: Ahan
authors.forename: Kwang-Yeol
authors.initials: KY
authors.lastname: Park
authors.forename: Oh-Sang
authors.initials: OS
authors.lastname: Kwon
mesh_terms: D000368:Aged; D001931:Brain Mapping; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006212:Hallucinations / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism*; D013788:Thalamus / Q000000981:diagnostic imaging / Q000378:metabolism*; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D004791:Enzyme Inhibitors; D014635:Valproic Acid