Hostname: page-component-7479d7b7d-qs9v7 Total loading time: 0 Render date: 2024-07-10T21:53:56.770Z Has data issue: false hasContentIssue false

Charles Bonnet Syndrome and Vitamin b12 Deficiency: A Case Report

Published online by Cambridge University Press:  16 April 2020

V. Bourgeois
Affiliation:
Pole Universitaire de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville les Rouen, Rouen, France
M. Desbordes
Affiliation:
Pole Universitaire de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville les Rouen, Rouen, France
M.-F. Rochard-Bouthier
Affiliation:
Pole Universitaire de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville les Rouen, Rouen, France
M. Follet
Affiliation:
Pole Universitaire de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville les Rouen, Rouen, France
G. Allio
Affiliation:
Pole Universitaire de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville les Rouen, Rouen, France
O. Guillin
Affiliation:
Pole Universitaire de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville les Rouen, Rouen, France Neuropsychopharmacology of Depression Unit, Institute for Biomedical Research, University of Rouen, Rouen, France
S. Haouzir
Affiliation:
Pole Universitaire de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville les Rouen, Rouen, France

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Visually impaired patients may experience complex visual hallucinations, a condition known as the Charles Bonnet syndrome (CBS). in the elderly, vitamin B12 deficiency has been implicated in various psychiatric conditions such as dementia, depression, delirium.

Here we report the case of 78 years old women with low vision due to bilateral glaucoma and unilateral cataract who was admitted in our psychogeriatric unit for complex and repetitive visual hallucinations (male characters, visions of her childhood), localized in external space that occurred acutely, inducing emotional distress and paranoia in response to the imagery. She had no past history of any psychiatric disorder. Psychiatric and physical exam, lab test, neuropsychological testing, EEG and brain CT scan ruled out visual hallucination due to dementia, epilepsy, delirium, psychosis. Therefore, criteria for CBS diagnosis were fulfilled.

Emotional distress was so intense that risperidone (1 mg/day) was started that permitted better insight within few days. Plasma vitamin B12 was low (< 44 pmol/L) unless normal red blood cell count. Supplementation with vitamin B12 (1mg/day) was started and plasma vitamin B12 increased within 1 month (198 pmol/L). in the same time, visual hallucinations disappeared and riperidone was stopped. Three month later, supplementation with vitamin B12 was stopped and visual hallucinations reappeared as plasma vitamin B12 was 87 pmol/L. Therefore, vitamin B12 alone (1 mg/day) was administered again and the CBS disappeared within 2 weeks.

To our knowledge, this is the first report of CBS associated with vitamin B12 deficiency successfully improved by vitamin B12 supplementation.

Type
P03-91
Copyright
Copyright © European Psychiatric Association 2009
Submit a response

Comments

No Comments have been published for this article.