Objective: Charles Bonnets has defined the visual hallucinations (VH) associated with macular degeneration; the syndrome (CBS) is to be remembered by his name. M

Background: Many other etiologies are also included in CBS etiology. However, VH can be related with neurological disorders such as Alzheimer’s disease, PD.

Methods: Right handed 55 year old man with a 2 year history of idiopathic PD. He was taking selegiline tablet 50 mg 2 times and pramipexole (PMX) tablet 1 mg 3 times. He had hypertension and arrhythmia. He complained began to see the film as if sleep on night since 2 months. His hallucinations form was moving and displaying of bedroom wall and ceiling. He said it was a room like fire and lights on fog. He expressed that light up curtains and touched on lost objects. This time it was open both eyes and hallucinations lasted a matter of minutes. Usually, he was aware of the hallucinations and felt they were not real. Contemplated of the patient’s symptoms were reduced evening dose of medication may be of PMX. Patient’s EEG, MRI and psychiatric evaluation were normal. Ophthalmic examination showed changes compatible with age, there is no glaucoma or cataract. Patient who has received doses of PMX night was interrupted. But didn’t a reduction in his complaint. Propranolol (120 mg/day) may be used for their complaints due to arrhythmia, cardiology consultation was requested. It was replaced with candesartan by cardiologist. His complaint has been significantly decreased 1 week later.

Results: To confirm the diagnosis of CBS many reasons should be excluded. Neurological causes like epilepsy, migraine, stroke, PD, LBD and requires exhaustive examination. However, should be excluded causes of toxic metabolic, infectious, drug use. CBS is most common in the elderly – patients’ mean age is 70 to 80 years; but it can occur in any age group. However, some CBS diagnosis can be made without visual damage. Deafferentation is one of the theories put forward in this disease. So causes of hallucination discharge that reduction of the visual cortex sensory input. VH in PD occur as a result of the discontinuation of attention mechanisms and neural network connection.

Conclusions: One of the behavioral side effects with low incidence of the β-blocker drugs are also hallucination. β-blocker drug also affect the central nervous system cross the blood-brain barrier. β-blocker drugs may lead to symptoms the reducing release of melatonin at night. CBS is still not illuminated every aspect of a situation. Patients should be questioned in more detail in the risk group.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/propranolol-induced-visual-hallucinations-a-case-report-charles-bonnets-syndrome-in-parkinson-disease/