EUR J OPHTHALMOL：邦纳综合征导致盲人看见东西

一位75岁妇女， 因患Usher综合征而完全丧失视力与听力，她来到西班牙马德里圣卡洛斯临床医院眼科，报告了一些奇怪症状：她晚上听见了小酒馆音乐，看见了医生所说的复杂视幻觉。

在进行彻底神经学检查之后，医生认为：这位妇女知道自己的现实，没有任何精神疾病或神经学问题。他们总结说，她不寻常感官经历是由一种邦纳综合征（Charles Bonnet syndrome）引起。

这项发现发表在2012年3月6日在线版 European Journal of Ophthalmology上。

瑞典哲学家Charles Bonnet于17世纪首次描述了这种疾病，因而该疾病命名为Charles Bonnet syndrome（邦纳综合征）。邦纳综合征是在心智正常的人身上发生的一种鲜明而复杂的幻觉，会偶然影响盲人或视力极弱的人。它也会发生在失去四肢的人身上，这些人会感觉到四肢的感觉。这些现象的原因是：控制四肢的大脑区域，或这种情况中控制视觉的大脑区域，在丧失四肢或视觉后继续活跃。

这例患Usher综合征的老年妇女病例不同于以前报道的病例，因为她还经历了听幻觉。她的医生称她的情况为邦纳综合征。

邦纳综合征患者已称"看见"从孩子到风景到建筑的许多种图像。有时，图像似乎很真实，有时很抽象，象卡通画或图型。在一个人静坐于昏暗光线中时，这种情况经常发生或变得活跃，并在光线变亮时消失。

尽管这种综合征可能令人恐惧，但它并不危险。但是，一个经历幻觉的人应该去看医生，以排除更严重的神经问题或药物的可能副反应。（生物谷bioon.com）

doi:10.5301/ejo.5000130
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Charles Bonnet plus syndrome: apropos of a case

Mercedes Serrador-García, Enrique Santos-Bueso, Federico Sáenz-Francés, David Díaz-Valle, José M. Martínez-De-La-Casa-Borrelia, Julián García-Feijóo

Purpose. Charles Bonnet syndrome plus is an exceedingly rare variant of this disorder. The variant has been described in patients with sight impairment and severe hypoacusis, and is usually characterized by complex visual and auditory-musical-hallucinations that the patients recognize as unreal. Method. Case report. Results. A 75-year-old woman diagnosed with Usher syndrome presented with visual acuity of light perception in both eyes, which did not improve with the use of a pinhole occluder. She also had coptosis in right ear and severe hypoacusis in left ear, confirmed through audiometry. Audiometric tests were normal once the implant and the hearing aid were connected. The patient was referred to the Neuro-Ophthalmology Unit after recounting experiencing complex visual hallucinations, as well as auditory (musical) ones at night after disconnecting the hearing aid. She described the latter as a nightly occurrence of hearing "cabaret music." Nevertheless, she was aware of reality and of her sensory impairments. The patient was diagnosed at the interdisciplinary Neuro-Ophthalmology Unit, and began pharmacologic treatment with clear improvement. Conclusions: Knowledge of Charles Bonnet syndrome and in particular of Charles Bonnet syndrome plus-due to its infrequency-on the part of ophthalmologists is fundamental to adequately diagnose and treat this rare disorder.