SÍNDROME DE CHARLES BONNET: UMA REVISÃO INTEGRATIVA

Abstract

Charles Bonnet Syndrome (SCB) is defined by complex visual hallucinations in patients without cognitive impairment and ophthalmologic disease accompanied by reduced visual acuity. It has benign character, the patient is aware of the unreal nature of the phenomenon and has been reported mainly in the elderly. SCB is an important differential diagnosis of dementia syndromes, and its correct diagnosis has a great impact on patients' quality of life, who suffer from the stigma of psychiatric illness, failure of established therapies and the possibility of imminent cognitive decline. It is possible to avoid this negative impact by clarifying the syndrome. Hence the relevance of information diffusion and correct clinical diagnosis. Objective: In this context, an integrative literature review was conducted to better characterize the CBS, to contribute to the dissemination of knowledge about the subject. Methodology: for the selection of articles were used those available in PUBMED and SCIELO databases; in the period between 2000 and 2017; in Portuguese and English; using the key words in the title: "Charles Bonnet Syndrome" or "Charles Bonnet Syndrome". Methodological quality was assessed by the STROBE and CARE criteria. Results and Discussion: We selected nine articles (three case series, five prevalence studies and one incidence study). CBS prevalence was very variable among the reviewed studies (0.4% and 34%) and the mean age was between 70 and 80 years. The characteristics of the identified hallucinations were: daily, weekly or monthly frequency; pictures may be in color or black and white, static or dynamic; the content can involve people, animals, objects, buildings and / or landscapes, full size or miniatures. The study of functional neuroimaging revealed increased unilateral activity in the temporal lobe, striatum and thalamus; areas involved in the process of perception and interpretation of the visual stimulus. There was no consensus on drug therapy in the present review. Most of the studies that address the clinical management of CBS are individual case studies or case series. However, authors argue that clarification about CBS and its benign nature reduced the discomfort caused by hallucinations in patients and thus drug therapy was dispensed by the patients themselves. Conclusion: More studies in the area are necessary to know the CBS and perform the differential diagnosis of dementia and psychiatric syndromes. This proposal will possibly bring great benefits to the health system and to those who experience CBS.