Coexistence of Charles Bonnet Syndrome and occipital epilepsy: A diagnostic challenge

Charles Bonnet Syndrome (CBS) is a condition characterized by complex visual hallucinations in individuals with visual impairment. We present the case of a patient with bilateral optic atrophy secondary to obstructive hydrocephalus caused by a pineal parenchymal tumor of intermediate differentiation (PPTID) who experienced formed visual hallucinations consistent with CBS. Following a right occipital craniotomy for occipital transtentorial approach and tumor resection, she developed elementary visual hallucinations. A thorough clinical history and systematic diagnostic evaluation led to the identification of coexisting right occipital epilepsy. This case highlights an intriguing overlap of two positive visual phenomena with distinct pathophysiological mechanisms.