The invisible small-sized man: a case of Charles Bonnet syndrome and literature review

Abstract

ObjectiveTo analyze the highlights of diagnosis and treatment of Charles Bonnet syndrome （CBS） and improve the level of diagnosis and treatment of CBS. MethodsOne case of CBS was reported. Literature review was conduced from PubMed, SinoMed,CNKI, Wanfang Data, Chongqing VIP and CMAPH using the searching words of “Charles Bonnet syndrome”, “hallucination” and “visual hallucination” in English and Chinese. Clinical data of retrieved cases were collected and analyzed. Results The patient presented with visual hallucination as the initial manifestation and complained of seeing “an invisible small-sized man” at home, whereas the patient understood that it was visual hallucination. No abnormality was found in mental assessment. The patient’s insight was not impaired and no other patterns of hallucination were found. The diagnosis of CBS was eventually confirmed. Cognitive therapy was given to this patient to deepen the understanding of CBS and reduce psychological burden. Fourteen CBS cases were retrieved by literature review, and they developed different patterns of visual hallucination. No effective drugs were available for visual hallucination. Conclusions It is difficult to make a diagnosis of CBS, there is no clear and effective treatment for it. Clinicians should pay more attention to improve the ability of diagnosis and treatment of CBS and lower the rates of misdiagnosis and mistreatment.

Keywords

• |charles bonnet syndrome|visual hallucination|nervous system disease