Little people - or also known as Lilliputian visions - are not uncommon in the land of Charles Bonnet syndrome. Many living with CBS report 'seeing' miniature people who are about the size of a finger. Such tiny people can be ‘seen’ directing a miniature horse-drawn carriage or driving a matchbox-sized vehicle. Sometimes, they are reported as being brightly constumed. Commonly, they comprise a mass procession like rows of a marching musical band or a phalanx of soldiers. These scenes tend to move across the person's visual field of view.
Another common occurrence (of a more personalised form) is where a little person is 'witnessed' from close range looking mischievously or curiously at them. Some living with CBS refer to their visions of little people as reminiscent of elves or Lilliputian.
The term 'Lilliputian' is drawn from the famous children's story, Gulliver's Travels, regarding Gulliver’s arrival at the land of Lilliput which is populated by tiny people. In 1909, Dr Raoul Leroy introduced the term to medical literature noting that Lilliputian hallucinations depicts seeing people, animals and objects of greatly reduced size. He noted such visions have been reported for aeons and that its medical causes are varied.
Hence, it is important to note that Lilliputian visions are not restricted to the CBS experience but can occur in a range of medical conditions including delirium, Parkinson’s disease, Dementia with Lewy Bodies and migraine attacks with visual aura. Therefore, one needs a thorough physical, neurological and psychiatric examination to establish its probable origin.