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Neurophenomenological Aspects of Monocular Visual Hallucinations in Charles Bonnet Syndrome in a patient with Parkinson’s Disease

D. Nolasco, A. Makarem, B. Buchowicz, L. Schmidt, B. Carr (Gainesville, USA)

Meeting: 2024 International Congress

Abstract Number: 1918

Keywords: Hallucinations

Category: Other

Objective: This inquiry aims to augment understanding of Charles Bonnet Syndrome (CBS) by scrutinizing both monocular and bilateral visual hallucinations. It focuses on an atypical instance of monocular hallucinations in a patient with Parkinson’s Disease, juxtaposed against a corpus of neuro-ophthalmological literature. The objective is to unravel the neurophenomenological underpinnings of CBS manifestations, especially why monocular presentations emerge despite the predilection for bilateral involvement in the implicated cerebral regions.

Background: CBS, traditionally associated with visual hallucinations in visually impaired individuals, is predominantly linked to bilateral deficits – a postulation grounded in the cerebral loci typically implicated in the syndrome. This exploration, however, foregrounds monocular hallucinations, amalgamating an exceptional case within a broad-based literature review. This approach aims to expand our comprehension of CBS, encompassing both unilateral and bilateral manifestations.

Method: This investigation melds an intricate case study of a patient with monocular CBS hallucinations with a review of relevant neuro-ophthalmological and neurophenomenological literature. This strategy facilitates a comprehensive dissection of the patient’s experiential narrative, positioned within the expansive spectrum of CBS research.

Results: The focal point is a patient with profound visual impairment in one eye, exhibiting hallucinations restricted to the affected visual domain. This case, in concert with scholarly findings, interrogates the convention of exclusively bilateral hallucinations in CBS. The collated data suggest that monocular hallucinations may emanate from intricate cortical adaptations in response to unilateral visual loss, invoking unique compensatory mechanisms or interhemispheric dynamics, contrary to traditional bilateral expectations.

Conclusion: The neurophenomenological dimensions of CBS, catalyzed by a singular clinical vignette and bolstered by an extensive literature survey, accentuates the cerebral complexity inherent in CBS. It broadens our comprehension beyond the usual bilateral paradigm, spotlighting cerebral plasticity in unilateral visual impairment scenarios. These insights underscore the merit of synthesizing individual case studies with comprehensive scholarly research to propel our understanding of neurological intricacies.

To cite this abstract in AMA style:

D. Nolasco, A. Makarem, B. Buchowicz, L. Schmidt, B. Carr. Neurophenomenological Aspects of Monocular Visual Hallucinations in Charles Bonnet Syndrome in a patient with Parkinson’s Disease [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/neurophenomenological-aspects-of-monocular-visual-hallucinations-in-charles-bonnet-syndrome-in-a-patient-with-parkinsons-disease/. Accessed June 15, 2025.
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