Complex Visual Hallucinations Following Stroke: Epileptic origin or a Deafferentation Phenomenon?

Objective: Complex and recurrent visual hallucinations are uncommon disorder in patients with visual pathway pathologic defects. Patients: To describe 8 patients that were diagnosed as having Charles Bonnet syndrome (CBS) after having experienced complex visual hallucinations following stroke involving occipital lobe. Two of these patients also had epileptic seizures. Results: Of 9560 patients with stroke in our Stroke Registry, 8 (0.08%) patients experienced a CBS following acute stroke. They had various complex visual hallucinations in their defective visual field. Hallucinations persisted for more than one month in half of the patients, and during hallucinations no electrographic seizures were recorded through a 24 hour video electroencephalographic monitoring. Conclusion: Charles Bonnet syndrome (CBS) may develop in patients with stroke involving occipital lobe following ischemic or hemorrhagic events. Charles Bonnet syndrome (CBS) associated with unilateral or bilateral medial occipital lesion and epilepsy may coexist and reflects the abnormal functioning of an integrated dorsal occipitoparietal processing system and ventral occipitotemporal processing neuronal network.