An 82-year-old female presents with a complaint of visual hallucinations. She has a past medical history of age-related macular degeneration, hypeension and hypercholesterolemia. On questioning, the patient repos seeing wild animals in her side room. She states that this has been happening for a year since she lost her sight but says she knows they are not real. MMSE = 28/30. What is the most likely diagnosis?
Correct Answer: Charles-Bonnet Syndrome
Description: Hallucinations are unreal : so Insight is present MMSE = 28/30 Therefore, No dementia as cut off for it is <24. Option A- seen in patients with recent onset stroke (MI) or patient recovering from very severe U.T.I Basically in delirium, patient cannot explain whether its Real or Unreal (i.e. cannot explain whatever he sees) Option B & C- Ruled out as dementia is absent. Option D- people who have turned blind but can still feel real or unreal i.e. INSIGHT is present in the patient. It is a type of Acquired Blindness Charles Bonnet syndrome(CBS) Disease in which visual hallucinations occur as a result of vision loss. CBS is not related to psychosis or dementia People with CBS are aware that their hallucinations are not real
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