Charles Bonnet Syndrome (CBS)

[Guest guest]

Dear Members,

 

As a registered nurse, I recently came across a patient with the most

unusual syndrome, called Charles Bonnet Syndrome (CBS) otherwise

known as "Phantom Vision." Those with this affliction are often

elderly or have had an injury to their optic center, or they have a

chronic eye disease. They are often hospitalized for mental illness

that is eventually ruled out in favor of this very bizarre visual

disturbance in which *elves* and various other "miniature

objects" are projected on their visual field. It is not a

psychological disorder per se, though the patients often begin to

feel very disturbed due to their ongoing visual hallucinations.

 

>From Wikipedia:

"Charles Bonnet syndrome (CBS) is named after the Swiss

naturalist Charles Bonnet. In 1760 he described a condition in which

vivid, complex visual hallucinations (fictive visual percepts) occur

in mentally healthy people. One characteristic of these

hallucinations is that they usually are 'lilliput hallucinations'

(hallucinations in which the characters or objects are smaller than

in reality)." Charles Bonnet first documented it in his 87 year old

grandfather, who was nearly blind from cataracts in both eyes but

perceived men, women, birds, carriages, buildings, tapestries, and

scaffolding patterns. Most who are affected by this are people with

visual impairments due to old age, damage to the eyes or optic

pathways. In particular, central vision loss due to a condition such

as macular degeneration combined with peripheral vision loss from

glaucoma may predispose to CBS, although most people with such

deficits do not develop the syndrome."

 

and for more information see:

<http://sprott.physics.wisc.edu/Pickover/pc/bonnet.html>

 

I am curious about how an Ayurvedic practitioner would view and treat

this syndrome.

 

Best,

JS

[Guest guest]

The vision is sensed through optic nerve, the second nerve amongst

twelve important nerves reaching the brain. Some description may be

found at:

 

http://www.meddean.luc.edu/lumen/MedED/GrossAnatomy/h_n/cn/cn1/mainfra

me.htm

 

According to Ayurveda, this in not a disease but a symptom of prana

vata disturbance. Prana vata is a subdosha of vata which resides in

the head and governs all higher brain functions. Thus carrying sesory

signals, their interpretations etc. If this condtition goes

untreated, other symptoms of prana vata disturbance may follow,

including anxiety, fear, nervousness, sleep disorder, tremors,

stuttering etc. There may be other symptoms of vata disturbance in

the eyes specifically dry eyes, itching, Sushruta says when vata

covered with doshas taking faulty passage get located in vision

carrying channels,then the patient perceives various types of visions.

 

Vata principle governs movements in the body like circulation,

digestive movements, sensory movement etc. It is made of air and

space elements. If vata gets vitiated air and space elements get

increased in physiology and disturb all the bodily functions of

movements. This leads to pressure in the head , nervous system,

dryness in the senses, vision distortion, double vision, shake in the

vision, tinnitus, loss of sleep, dry scalp, dry skin , tendency of

instability, anxietys, nervousness etc. Distortion in the vision is

experienced only by the patient, it is not external, it is internal,

it is not the persons imagination it is result of internal, vata,

imbalance. This is similar to vibrations experienced in Kampvata,

where tremors arise for no external reason. This is also similar to

Tinnitus, where noises heard by the patient are internal. In these

cases, it is seen that the effect of internal noise is highest when

there is no external signal, as in Tinnitus. And the case mentioned

by you, as also wikipedia info states that such problems become more

likely after vision loss due to Macular degeneration or loss of

peripherial vision. This is consistent with all scientific electronic

instruments, where noise/signal ratio is highest when external signal

is missing. Once the radio receiver is tuned to the station frequency

you receive better signal.

 

Because every individual has a different body constitution , the

symptoms vary in different type of people. Similar disease is

multiple sclerosis, parkinsononism where control by the nerves is

weakened. Modern science finds reasons in some deficiency in the

hormones/chemicals/neurotransmitters etc.

 

The aggravation may lead to vision loss. It may not be necessary

that all such cases cause blindness. People with high vata imbalance,

vata body type are more prone to aggravation. One patient of this

author suffering from head aches caused by a tumor was treated by

steroids and he lost vision gradually. Head ache did not vanish,

hence he visited this author, and was cured by using PanchGavya

medicines. This case is referred in earlier message# 6878. Other

symptoms could be concentration problems, sleeping problems,

irritation and annoyance, hypersensitivity to sounds, or increased

sensitivity to vision disturbances when eyes are closed. Chronicity

of such problem causes despair, frustration and depression in many

people.

Possible reasons for this condition may be working in excessive

lights, a benign (non-cancerous) tumour of the optic nerve, which

carries signals from the eyes to the brain, high doses of drugs

including aspirin, quinine and some antibiotics, head injury,

disorders of the heart and blood vessels, particularly in the head,

high blood pressure· Benign tumor near the pituitary gland could

also be the reason. Modern science often describes this as atrophy of

the relevant centers in the brain, processing specific signals.

 

The Vata balancing therapies and herbs will be beneficial. Vacha

(Acorus calamus) oil nasya, has a powerful effect in calming and

balancing the Prana vata. A preparation of sesame oil medicated with

calamus root should be taken nasally, five drops per nostril, at

night and in the morning. The nasya should be warmed to blood heat

before administration. nasya helps to nourish the senses to eliminate

excess vata from senses. Abhyanga (Massage) Shiroabhyanga(head

massage) and padabhyanga(Foot massage), wherein the soles of the feet

are massaged with warm sesame oil, has a specific effect in calming

the prana vata. At bedtime, warm sesame oil should be applied to the

soles of the feet and also to the scalp. This treatment rapidly

normalizes the prana vata. Even though the problem pertains to

vision, karna-pooran(Ear drops) ten drops of warm sesame oil should

be applied daily to each ear. The oil is allowed to remain in the

first ear for five or ten minutes, then that ear is cleaned, and the

same procedure is followed with the other ear, with the patient lying

on the other side. The improvements should be seen in a fortnight.

Dashmool tail can also be used for Karnpooran.

 

Kawala Gargling of medicated oils or certain liquids/Kwath is

Kawala.It strengthens the nerves of eyes and ears and also pacifies

aggravated vata.

 

Gandusha Withholding medicated oils or certain liquids in the mouth

for a certain period of time is known as Gandusha and has the same

benefit as Kawala.

 

Eyedrops: Using Triphala quath for eyewash and triphala ghrutam as

ointment at bedtime may help. These are all possible treatments, but

consultation with a nearby Vaidya would sharpen the protocol.

 

Herbs and Formulations

Oral administration of sarasvat churna can be given in doses of a

quarter teaspoon twice daily after meals. Kaunch and Aswagandha

powder mixture, about 250 mg in honey can be taken thrice a day. The

ration can be worked out by a vaidya after pulse check.

 

Brahmi, Ashwagandha,Jatamansi,Dashmool,Vacha, Yeshtimadhu are the

herbs and formulations like 101 avartit Ksheerbala , Triphla Ghrutam,

Anu tail, Brahmi ghrit can be used. The dosages can be decided again

by actual consultation.

 

Lifestyle Changes

Consumption of caffeine, nicotine, or cocaine can disturb the prana

vata leading to such distortions, as can excess television watching,

excess use of computers, or sleeping near an electrical outlet.

Moderation in sensory activities.especially watching strong lights,

welding flame, sparks, and professional activities which involve

high frequency radiations encountered in X-rays, gamma rays,

environment in radiology labs etc.

 

Last but most important:

The patient may benifit by breathing techniques which involve high

volume breathing rapidly, so that oxygen to brain is increased, as

also by Kapal Bhatti which increases breathing capacity. Author has

seen an amzing improvement in hearing in case of pateint mentioned in

message# 6878.

 

ayurveda, "jai.ma" <jai.ma wrote:

As a registered nurse, I recently came across a patient with the most

> unusual syndrome, called Charles Bonnet Syndrome (CBS) otherwise

> known as "Phantom Vision." Those with this affliction are often

> elderly or have had an injury to their optic center, or they have a

> chronic eye disease. They are often hospitalized for mental illness

> that is eventually ruled out in favor of this very bizarre visual

> disturbance in which *elves* and various other "miniature

> objects" are projected on their visual field. It is not a

> psychological disorder per se, though the patients often begin to

> feel very disturbed due to their ongoing visual hallucinations.

>

> From Wikipedia:

> "Charles Bonnet syndrome (CBS) is named after the Swiss

> naturalist Charles Bonnet. In 1760 he described a condition in

which

> vivid, complex visual hallucinations (fictive visual percepts)

occur

> in mentally healthy people. One characteristic of these

> hallucinations is that they usually are 'lilliput hallucinations'

> (hallucinations in which the characters or objects are smaller than

> in reality)." Charles Bonnet first documented it in his 87 year old

> grandfather, who was nearly blind from cataracts in both eyes but

> perceived men, women, birds, carriages, buildings, tapestries, and

> scaffolding patterns. Most who are affected by this are people with

> visual impairments due to old age, damage to the eyes or optic

> pathways. In particular, central vision loss due to a condition

such

> as macular degeneration combined with peripheral vision loss from

> glaucoma may predispose to CBS, although most people with such

> deficits do not develop the syndrome."

>

> and for more information see:

> <http://sprott.physics.wisc.edu/Pickover/pc/bonnet.html>