Bonnet syndrome and posterior parasagittal tumor: clues to neural, mechanisms

Ribeiro, S. A.; Oliveira-Souza, R.; Alvarenga, H.

doi:10.1590/S0004-282X1989000200016

Abstracts

A case of Bonnet syndrome associated with blindness due to bilateral eye disease and a posterior parasagittal meningioma is reported. It is assumed that visual afferent deprivation alone is not enough to produce the syndrome and that, in most instances, a 'cerebral factor' must be operative if hallucinoses are to occur. The distinction between hallucinosis and hallucinations is favored and a common neural circuit for the mediation of hallucinotic imageries in general is suggested. One should not immediately put the blame on obvious eye or visual pathways affections when facing cases of Bonnet syndrome, as they are not likely to explain the complex array of images perceived by any given patient. On the contrary, the possibility of a clinically covert intracranial disease should be always raised and intensively looked for.

Relatamos o caso de um paciente com síndrome de Bonnet com cegueira ocasionada por doença ocular bilateral e meningeoma parassagital posterior. Admite-se que, isoladamente, a deprivação visual aferente é insuficiente para produzir a síndrome e que, na maior parte dos casos, um 'fator cerebral' deve operar para que a alucinose aconteça. Favorecemos a distinção entre alucinose e alucinação e sugerimos que um circuito neural comum medeie as imagens alucinóticas de modo geral. Não parece prudente responsabilizar de imediato afecções oculares ou ópticas óbvias quando diante de casos de síndrome de Bonnet, pois, provavelmente, não justificarão as imagens complexas percebidas pelo paciente. Ao contrário, deve-se investigar exaustivamente a possibilidade de doenças intracranianas clinicamente inaparentes.

Bonnet syndrome and posterior parasagittal tumor: clues to neural, mechanisms

Síndrome de Bonnet e tumor parassagital posterior: indícios dos mecanismos neurais

S. A. Ribeiro; R. Oliveira-Souza; H. Alvarenga

Serviço de Neurologia, Hospital Universitário Gaffrée e Guinle, Universidade do Rio de Janeiro (UNI-RIO)

SUMMARY

A case of Bonnet syndrome associated with blindness due to bilateral eye disease and a posterior parasagittal meningioma is reported. It is assumed that visual afferent deprivation alone is not enough to produce the syndrome and that, in most instances, a 'cerebral factor' must be operative if hallucinoses are to occur. The distinction between hallucinosis and hallucinations is favored and a common neural circuit for the mediation of hallucinotic imageries in general is suggested. One should not immediately put the blame on obvious eye or visual pathways affections when facing cases of Bonnet syndrome, as they are not likely to explain the complex array of images perceived by any given patient. On the contrary, the possibility of a clinically covert intracranial disease should be always raised and intensively looked for.

RESUMO

Relatamos o caso de um paciente com síndrome de Bonnet com cegueira ocasionada por doença ocular bilateral e meningeoma parassagital posterior. Admite-se que, isoladamente, a deprivação visual aferente é insuficiente para produzir a síndrome e que, na maior parte dos casos, um 'fator cerebral' deve operar para que a alucinose aconteça. Favorecemos a distinção entre alucinose e alucinação e sugerimos que um circuito neural comum medeie as imagens alucinóticas de modo geral. Não parece prudente responsabilizar de imediato afecções oculares ou ópticas óbvias quando diante de casos de síndrome de Bonnet, pois, provavelmente, não justificarão as imagens complexas percebidas pelo paciente. Ao contrário, deve-se investigar exaustivamente a possibilidade de doenças intracranianas clinicamente inaparentes.

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Br. R. de Oliveira Souza - Rua General Belford 226 - 20961 Rio de Janeiro RJ - Brasil.

1. Adams RD, Victor MB - Principles of Neurology. Ed 3. McGraw-Hill, New York, 1985.
2. Alajouanine T, Thurel R, Durupt L - Lésion protubérantielle basale d'origine vasculaire et hallucinose. Rev Neurol (Paris) 76: 90, 1944.
3. Asaad G, Shapiro B - Hallucinations: theoretical and clinical overview. Am J Psychiat 143:1088, 1986.
4. Berrios GE - Hallucinosis. In: Fredriks JAM (ed): Neurobehavioral Disorders. Handbook of Clinical Neurology. Vol 46/2. Elsevier, Amsterdam, 1985.
5. Bogaert L - L.'hallucinose pédonculaire. Rev Neurol (Paris) 2: 102, 1927.
6. Brust JCM, Behrens MM - 'Release hallucinations' as the major symptom of posterior cerebral artery occlusion: a report of two cases. Ann Neurol 2: 432, 1977.
7. Caplan LR - 'Top of the basilar' syndrome. Neurology 30: 72, 1980.
8. Cogan DC - Visual hallucinations as release phenomena. Albrecht v Graefes Arch klin exp Ophtalm 188: 139, 1973.
9. Dunn DW, Weisberg LA, Nadell J - Peduncular hallucinosis caused by brainstem compression. Neurology 33: 1360, 1983.
10. Editorial - Localisation of visual hallucinations. Br Med J 2: 147, 1977.
11. Goodkin DA - Mechanisms of bromocriptine-induced hallucinations. N Engl J Med 302: 1479, 1980.
12. Hart CT - Formed visual hallucinations: a symptom of cranial arteritis.
13. Horrax G - Visual hallucinations as a cerebral localizing phenomenon. Arch Neurol Psychiat 10: 532, 1923.
14. Lance JW - Simple, formed hallucinations confined to the area of a specific visual field defect. Brain 99: 719, 1976.
15. Lee SH, Rao KCVG - Primary tumors in adults. In Lee SH, Rao KCVG (eds): Cranial Computed Tomography. McGraw-Hill, New York, 1983.
16. Lhermitte J - Syndrome de la calotte du pédoncule cérébral: les troubles psycho-sensoriels dans les lésions du mésocephale. Rev Neurol (Paris) 38: 1359, 1952.
17. McNamara ME, Heros RC, Boller F - Visual hallucinations in blindness: the Charles Bonnet syndrome. Int J Neurosci 17: 13, 1982.
18. Mooney AJ, Carey P, Ryan M, Bofin P - Parasagittal parieto-occipital meningioma. Am J Ophtalm 59: 197, 1965.
19. Morsier G - Le syndrome de Charles Bonnet: hallucinations visuelles des veillards sans déficience mentale. Ann Méd-Psychol 2: 677, 1967.
20. Popow M - Contribuition à l'étude du syndrome de Lhermitte. Rev Neurol (Paris) 2: 102, 1934.
21. Rolak LA, Baram TZ - Visual hallucinations: more diagnoses. J Am Med Ass 257: 2036, 1987.
22. Rozanski J - Peduncular hallucinosis following vertebral angiography. Neurology 2: 341, 1952.
23. Sowa MV, Beach CA, Pituck S - Prolonged spontaneous complex visual hallucinations and illusions as ictal phenomena. Neurology 37, suppl 1: 238, 1987.
24. Symonds C, MacKenzie I - Bilateral loss of vision from cerebral infarction. Brain 80: 415, 1957.
25. Weinberger LM, Grant FC - Visual hallucinations and their neuro-optical correlates. Arch Ophtalm 23: 166, 1940.
26. White NT - Complex visual hallucinations in partial blindness due to eye disease. Br J Psychiat 136: 284, 1980.

Publication Dates

Publication in this collection
06 June 2011
Date of issue
June 1989

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adams RD, Victor MB - Principles of Neurology. Ed 3. McGraw-Hill, New York, 1985.

[2] 2. Alajouanine T, Thurel R, Durupt L - Lésion protubérantielle basale d'origine vasculaire et hallucinose. Rev Neurol (Paris) 76: 90, 1944.

[3] 3. Asaad G, Shapiro B - Hallucinations: theoretical and clinical overview. Am J Psychiat 143:1088, 1986.

[4] 4. Berrios GE - Hallucinosis. In: Fredriks JAM (ed): Neurobehavioral Disorders. Handbook of Clinical Neurology. Vol 46/2. Elsevier, Amsterdam, 1985.

[5] 5. Bogaert L - L.'hallucinose pédonculaire. Rev Neurol (Paris) 2: 102, 1927.

[6] 6. Brust JCM, Behrens MM - 'Release hallucinations' as the major symptom of posterior cerebral artery occlusion: a report of two cases. Ann Neurol 2: 432, 1977.

[7] 7. Caplan LR - 'Top of the basilar' syndrome. Neurology 30: 72, 1980.

[8] 8. Cogan DC - Visual hallucinations as release phenomena. Albrecht v Graefes Arch klin exp Ophtalm 188: 139, 1973.

[9] 9. Dunn DW, Weisberg LA, Nadell J - Peduncular hallucinosis caused by brainstem compression. Neurology 33: 1360, 1983.

[10] 10. Editorial - Localisation of visual hallucinations. Br Med J 2: 147, 1977.

[11] 11. Goodkin DA - Mechanisms of bromocriptine-induced hallucinations. N Engl J Med 302: 1479, 1980.

[12] 12. Hart CT - Formed visual hallucinations: a symptom of cranial arteritis.

[13] 13. Horrax G - Visual hallucinations as a cerebral localizing phenomenon. Arch Neurol Psychiat 10: 532, 1923.

[14] 14. Lance JW - Simple, formed hallucinations confined to the area of a specific visual field defect. Brain 99: 719, 1976.

[15] 15. Lee SH, Rao KCVG - Primary tumors in adults. In Lee SH, Rao KCVG (eds): Cranial Computed Tomography. McGraw-Hill, New York, 1983.

[16] 16. Lhermitte J - Syndrome de la calotte du pédoncule cérébral: les troubles psycho-sensoriels dans les lésions du mésocephale. Rev Neurol (Paris) 38: 1359, 1952.

[17] 17. McNamara ME, Heros RC, Boller F - Visual hallucinations in blindness: the Charles Bonnet syndrome. Int J Neurosci 17: 13, 1982.

[18] 18. Mooney AJ, Carey P, Ryan M, Bofin P - Parasagittal parieto-occipital meningioma. Am J Ophtalm 59: 197, 1965.

[19] 19. Morsier G - Le syndrome de Charles Bonnet: hallucinations visuelles des veillards sans déficience mentale. Ann Méd-Psychol 2: 677, 1967.

[20] 20. Popow M - Contribuition à l'étude du syndrome de Lhermitte. Rev Neurol (Paris) 2: 102, 1934.

[21] 21. Rolak LA, Baram TZ - Visual hallucinations: more diagnoses. J Am Med Ass 257: 2036, 1987.

[22] 22. Rozanski J - Peduncular hallucinosis following vertebral angiography. Neurology 2: 341, 1952.

[23] 23. Sowa MV, Beach CA, Pituck S - Prolonged spontaneous complex visual hallucinations and illusions as ictal phenomena. Neurology 37, suppl 1: 238, 1987.

[24] 24. Symonds C, MacKenzie I - Bilateral loss of vision from cerebral infarction. Brain 80: 415, 1957.

[25] 25. Weinberger LM, Grant FC - Visual hallucinations and their neuro-optical correlates. Arch Ophtalm 23: 166, 1940.

[26] 26. White NT - Complex visual hallucinations in partial blindness due to eye disease. Br J Psychiat 136: 284, 1980.