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Charles Bonnet syndrome (CBS) is defined like visual hallucinations found in individuals who are not necessarily mentally ill, who have visual impairment and no cognitive deficits. Although CBS make reference to visual hallucinations, in this case we are going to deal about Auditory Charles Bonnet Syndrome (aCBS), a very infrequent condition that consists in the presentation of musical hallucinations in patients with sensorineural hearing loss and which etiology is not clearly due to a psychiatric condition.
Objectives
Review the scientific literature available on aCBS to see how much we know about this syndrome.
Methods
Review of available literature sources were obtained through electronic search in PubMed database.
Results
Musical hallucination is a complex form of auditory hallucinations. The most common of these are idiopathic and they present in elderly patients with deafness or impaired audition, which suggests a deterioration of cerebral function. The pathophysiologic mechanism is not understood. These patients tend to have intact reality tests. The time course is variable. In those cases in which it is possible, treating the hearing loss can lead to a significant improvement of the symptom. However, when every this strategies are insufficient, pharmacological treatments can be considered.
Conclusions
- aCBS is an uncommon condition characterized by the presence of complex auditory hallucinations that mainly affect elderly patients with hearing loss. - In most cases there is no previous psychiatric history. - The etiology and pathophysioplogic are not well defined. - There is no etiological treatment. We can use pharmacological and no pharmacological methods of treatment.
This chapter talks about Mary who was admitted to Tertiary Hospital in early June of 2003 having stumbled to the ground being unable to get up. CT of her head confirmed general parenchymal volume loss with decreased attenuation periventricularly. No significant areas of ischemia or space-occupying lesions were noted. PET scan was suggestive of a neurodegenerative process of Alzheimer's type. No scan evidence of frontal lobe dementia. The diagnosis prior to the PET scan being performed was frontotemporal dementia. The final clinical diagnosis after the PET scan and on discharge was that of Alzheimer's type dementia. She was not started on acetylcholine esterase therapy. She was discharged to a low level residential facility. This case is interesting in that it does not on face value fit into one category of neurodegenerative disorders. False beliefs related to misinterpretation of the environment due to significant visual impairment is known as Charles-Bonnet syndrome.
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