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Charles Bonnet syndrome: an example of cortical dissociation syndrome affecting vision?
  1. M COLE
  1. Department of Neurology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH44106–5000, USA
  1. mcole{at}

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This letter is a response to that by Abhijit Chaudhuri.1 I thank Chaudhuri for his kind comments, but will address his surprise that I did not comment on the Charles Bonnet syndrome in my 1999 paper.2

Chaudhuri and his associates cannot be really criticised for using the eponym “Charles Bonnet syndrome” for the “triad of visual hallucinations, visual sensory deprivation, and preserved cognitive status” as there is support in the literature for the use of the eponym in this way. But I favour the use of the eponym, if it is to be used at all, only in patients with eye disease. This was what Charles Bonnet described,3 and the way the term was initially used by de Morsier in 1936.4 I highly recommend the paper by ffytche and Howard5 in which the authors provide an excellent summary of Charles Bonnet syndrome on pages 1253–1254. I agree with the way that they accept the use of the term, and their reason for doing so. It is, thus, a matter of personal opinion as to how the eponym should be used. It was never used in any of the references in my 1999 paper, but I did not choose the references with this reason in mind.

Is there any reason to use the eponym at all? It may remind ophthalmologists that visual hallucinations can occur with ocular disease and do not necessarily suggest a neurological lesion. But, as the eponym has now acquired two different meanings I think that it leads to more confusion than clarification. Chaudhuri's communication is a good example. I would thus suggest that it no longer be used. I did not use the term because I did not, and do not, think that the subject of my report (myself) has the Charles Bonnet syndrome. Nor, presumably, did the reviewers of my paper and the Editor of thisJournal.

Finally, I must tell Chaudhuri that “advanced age” hardly begins at 60 years.


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