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PubMed2005

[Tactile hallucinations induced by trihexyphenidyl in a patient with Parkinson's disease].

We report a 71-year-old woman with tactile hallucinations induced by trihexyphenidyl. Six and a half months after starting trihexyphenidyl, this patient with Parkinson's disease complained of tactile hallucinations, mainly on her feet, at night while in bed. Four days after stopping the medication, the sensations disappeared. Although tactile hallucinations induced by trihexyphenidyl are rare, it should be noted that the condition can be induced by anti-Parkinson's disease drugs.

Aged↗
PubMed2005

Audiovisual peduncular hallucinations: a release of cross-modal integration sites?

We report the case of a patient with multiple sclerosis with congruent visual and auditory hallucinations of deceased familiar persons that lasted continuously for several days. Magnetic resonance imaging revealed an isolated, predominantly left-sided lesion in the periaqueductal segment of the mesencephalon. We propose that these hallucinations represent a bimodal variant of classic peduncular hallucinations, brought about by a deregulation of modulatory superior collicular activity and a release of cross-modal integrative functions of the superior temporal sulcus.

Adult↗
PubMed2006

[Rivastigmine as adjunctive therapy in the therapeutic dilemma for the treatment of hallucinations due to Parkinson disease].

We report three cases of patients with Parkinson's disease without dementia, admitted to our hospital because of hallucinations. The anti-Parkinson medication was adapted and the patients started with rivastigmine. As a result, hallucinations no longer occurred. A 79 years old man also required short-term quetiapine because of agitation and anti-Parkinson doses were without side effects, as a result of which mobility improved. An 84 years old woman reported mild side effects of rivastigmine, without consequences, whereas her mobility appeared to be good. A 72 years old woman reported mild memory problems upon admission, which improved during admission, as did her mobility after increasing the anti-Parkinson medication doses. Treatment of rivastigmine can be useful in the therapeutic dilemma in the treatment of hallucinations in patients with Parkinson's disease (start anti-psychotic or reduce anti-Parkinson medication). In addition to adapting anti-Parkinson doses and sometimes short-term treating with an anti-psychotic, treatment with rivastigmine appears to be a quick improvement, without serious side effects. Also, mobility can improve, due to the possibility of increasing the anti-Parkinson doses, if necessary. Because of the many remaining questions, prospective randomised trials are needed.

Aged↗
PubMed1989

Observation on the curative effect of 120 cases of auditory hallucination treated with auricular acupuncture.

Auditory hallucination often affects the thinking and emotion of the patients leading to dangerous behaviour of injuring themselves or others. We have treated auditory hallucination with different kinds of psychosis, mainly using auricular acupuncture and yielding certain curative effect. In our series, we found that there is no obvious correlation between number of attacks and the curative effect; however the duration of each attack may affect the curative effect. We also noticed that there is no significant difference in curative effects among the groups of simple auricular acupuncture, auricular plus body acupuncture and auricular acupuncture plus chlorpromazine. Therefore, we recommend auricular acupuncture for treating auditory hallucination.

Acupuncture Therapy↗
PubMed1986

Visual hallucinations: meaning and management.

Visual hallucinations of low vision patients may serve as indicators of trauma, illness and psychological disturbance or concerns. Routine inquiry about them is suggested and two case illustrations of this procedure are presented. Primary consideration is management of patient anxiety and fear, as well as indications for referral to allied professions. The incidence of hallucinations is very likely under-reported, though detailed exploration of the parameters of hallucinations in the visually impaired population can enhance existing knowledge and often alleviate fears of mental illness.

Blindness↗
PubMed1984

Hostage hallucinations. Visual imagery induced by isolation and life-threatening stress.

The literature on hallucinatory experiences of hostage victims is reviewed. The phenomenology is examined in 30 case studies involving 31 persons, including ex-prisoners of war and victims of rape, kidnapping, terrorism, robbery, and "UFO abductions." The victims were subjected to conditions of isolation, visual deprivation, restraint on physical movement, physical abuse, and the threat of death. For eight victims, these conditions were sufficient to produce a progression of visual hallucinations from simple geometric images to complex memory images coupled with dissociation. The other 23 victims, subjected to similar conditions but without isolation and life-threatening stress, resulting from the threat of death, did not experience hallucinations. The hostage hallucinations are compared to those resulting from sensory deprivation, near fatal accidents, and other states of isolation and stress. A common mechanism of action based on entoptic phenomena and CNS excitation and arousal is suggested.

Accidents↗
PubMed1981

A snake lady: post-concussion syndrome manifesting visual hallucinations of snakes.

A 37-year-old female was referred to the Department of Psychiatry at the University of Iowa with visual hallucinations of snakes that began ten months after a brief loss of consciousness in a car accident. She also complained about a persistent headache and depressed mood that began shortly after the accident. Her depressive symptoms did not respond to amitriptyline or ECT. By thoroughly reviewing the clinical features and course of this patient, we conclude that the she did not have a typical, definite psychiatric syndrome explaining her hallucinations. The hallucination of snakes in this case may be a manifestation of post-concussional syndrome.

Adult↗
PubMed1981

Hallucinations and delusions in black psychiatric patients.

A higher incidence of hallucinations has been previously reported among blacks, as compared to whites, in both psychiatric and nonpsychiatric populations. In contrast to these reports, which relied on hospital records, the present study utilized standardized research rating scales, and confirmed the above observation among schizophrenic patients. Some blacks, irrespective of diagnosis, probably experience a variety of non-schizophrenic hallucinations, may lead to erroneous diagnoses of schizophrenia. Current ignorance regarding the content of hallucinations in normal and non-schizophrenic, and in schizophrenic blacks is a source of diagnostic confusion which may have dire consequences for many individuals.

Adult↗
PubMedDate not supplied

Visual hallucinations evoked by caloric vestibular stimulation in normal humans.

This study describes a hitherto unknown phenomenon in healthy humans: visual hallucinations evoked by caloric vestibular stimulation. The hallucinations are of elementary type. The following quantitative and qualitative characteristics of the hallucinatory images were measured: latency, duration, location in the visual field, relation to the provoked vertigo, colour of the hallucinatory image and the background, number, size, shape, distance from the eyes, and motion. Two mechanisms are proposed to explain the genesis of these hallucinations. One mechanism is direct: change in the spontaneous activity of the visual system in several levels; the other mechanism is indirect: transient haemodynamic disturbance in the visual system.

Adolescent↗
PubMedDate not supplied

[Insomnia and hallucinations caused by vascular lesions of the pontine].

Small ischemic vascular lesions or hemorrhages provide a pathological model useful for the study of sleep disturbances in human due to lesions in the pontine tegmentum. We present 7 patients, 4 men and 3 women, with severe insomnia and hallucinations due to small vascular lesions of the pontine tegmentum. Nocturnal-sleep and/or 24-h polygraphic studies were done on all patients, as were neurophysiological and image studies; pathological studies were performed in one patient. Insomnia affected both non-REM and REM sleep, appeared in the acute phase and tended to improve with time. The patients tolerated insomnia with no serious effects on general health. Insomnia was not affected by administration of L-tryptophan with or without carbidopa. Hallucinations were mainly visual, but were also auditory in 2 cases; they were unrelated to the occurrence of normal or dissociated REM sleep. Imaging studies, and autopsy in 1 case, revealed damage to the pontis centralis caudalis and pontis centralis oralis nuclei, which appeared to be responsible for insomnia. The relationship between visual and/or auditory hallucinations and sleep disturbances remain speculative.

Aged↗
PubMed1993

[Appearance of hallucinations and one-and-a-half syndrome after resection of a cavernous angioma located in the fourth ventricle floor].

A patient is described who simultaneously suffered from hallucinations and one-and-a-half syndrome following surgical resection of a cavernous angioma located on the fourth ventricle floor. A 30-year-old male was admitted having a 10 year history of progressive weakness and hypesthesia of the right extremities. Neurological examination revealed right hemiparesis and hemihypesthesia. A computerized tomography (CT) scan showed a well circumscribed mixed-density area at the left portion of the pontine tegmentum. Magnetic resonance imaging (MRI) indicated a mixed intensity core surrounded by hypointense regions on T2-weighted images. A red mulberry-like tumor was found, during surgical procedures, on the mid-and left-portion of the fourth ventricle floor. The tumor was totally resected and the histological diagnosis was cavernous angioma. Visual hallucinations occurred several times following surgery, being subsequently described as images of moving worms, a dump truck next to the bed, and a bed falling from the ceiling. The patient soon understood these objects were not real. He simultaneously exhibited left lateral gaze palsy associated with left internuclear ophthalmoplegia i.e., one-and-a-half syndrome. Three months after surgery the visual hallucinations disappeared but the one-and-a-half syndrome was incompletely resolved. According to the neurological signs and the MRI results, the lesion site was considered to extend from the left lower pons to the midbrain. Previously reported operations of cavernous angioma of the fourth ventricle floor are also described.

Adult↗
PubMed1977

Hallucinations as a conversion reaction.

This clinical report describes a patient who experienced complex visual and auditory hallucinations as a conversion reaction. The evidence suggests that hallucinations as a conversion reaction are qualitatively different from other types of hallucinations.

Adolescent↗
PubMedDate not supplied

Visual hallucinations.

Hallucinations may be defined as perceptions that occur in the absence of a corresponding stimulus. They can involve any of the five senses, hence visual, auditory, tactile, gustatory and olfactory hallucinations. By contrast, illusions depend upon a misinterpretation of an external stimulus. In this review we outline the causes, and describe the characteristics of various hallucinatory states. This should help in the assessment of a patient presenting with visual hallucinations.

Eye Diseases↗
PubMed1997

[Acoustic hallucinations as a symptom of a REM sleep-associated parasomnia].

This 52-year-old man suffered from auditory hallucinations that occurred during brief episodes of sleep paralysis at the end of REM sleep periods. During these episodes the patient experienced a dissociated state of consciousness with REM sleep intrusions into wakefulness. The occurrence of this mixed state, and of excessive sleep-onset REM periods during daytime polysomnography (MSLT = Multiple Sleep Latency Test), point to a disorder of REM sleep generation. The existence of narcolepsy could be ruled out. The observation of REM sleep-associated hallucinations has been reported earlier. In the presented polysomnographic sleep studies the existence of a REM sleep associated parasomnia characterised by hallucinations and sleep paralysis could be confirmed.

Acoustic Stimulation↗
PubMed1998

Delusions and hallucinations in an adult day care population. A longitudinal study.

The frequency of the manifestation of delusions and hallucinations (d/h) among participants of adult day care centers was examined, as was the relationship of d/h to demographic and medical variables, agitation, depressed affect, and dementia. Changes in d/h were also assessed over a 1-year period, and those changes were compared with changes in agitation, depressed affect, and dementia. Depressed affect and agitation were related both to delusions and to hallucinations. Dementia was also related to d/h, although a substantial percentage of individuals who were not diagnosed with dementia also experienced some type of d/h. Finally, delusions were more prevalent and generally tended to relate more strongly to agitation, depressed affect, and dementia than did hallucinations.

Aged↗
PubMed1976

Human EEG spectra before and during cannabis hallucinations.

EEG correlates of subjective experiences induced by delta9-trans-tetrahydrocannabinol (THC) and EEG correlates of individual disposition to such experiences were investigated. Twelve normal volunteers took 200 mug/kg THC orally. The subjects were asked to signal subjective experiences. The EEG was analyzed (period analysis) before and repeatedly after THC injestion, during resting, attention, eye closure, visual hallucinations, and body image disturbances. EEG frequency spectra differed significantly between resting and visual hallucinations and body image disturbances. The differences included slower alpha and more theta during THC experiences, reminiscent of initial drowsiness EEG, and of some results in schizophrenia. The differences between spectra during visual hallucinations and during body image disturbances indicate different functional brain states. Subjects with a high tendency to cannabinol induced experiences exhibited resting spectra before and after THC with higher modal alpha frequences (reminiscent of subjects with high neuroticism scores) than subjects with a low tendency.

Adult↗
PubMed2000

Electrical cortical stimulation of the human prefrontal cortex evokes complex visual hallucinations.

Complex visual hallucinations are a well-known feature of electrical stimulation or epileptic discharge in the temporal lobe. It has been proposed that these visual hallucinations result from an electrical interference with the ventral visual processing stream in the lateral temporal lobe and the memory system in medial temporal structures, which explains their frequent visual and mnestic features. Even though recent studies have demonstrated visual and memory functions in the prefrontal cortex, up to now epileptic discharge or electrical stimulation of prefrontal structures has only rarely been reported to induce visual phenomena. We report on two patients undergoing invasive presurgical epilepsy evaluation in which electrical cortical stimulation of the left prefrontal cortex repeatedly induced complex visual hallucinations. Interestingly, the induced visual responses differed with respect to their spatial organization: whereas those evoked on the inferior frontal gyrus were perceived in the whole visual field, complex visual responses on the middle frontal gyrus were restricted to the contralateral hemispace. Based on the spatial organization of the visual experiences in our patients, animal work, and neuroimaging data it might be suggested that specific subregions of the human prefrontal cortex might contain separate visual and mnemonic processing mechanisms.

Journal Article↗
PubMedDate not supplied

Compelling imagery, unanticipated speech and deceptive memory: neurocognitive models of auditory verbal hallucinations in schizophrenia.

INTRODUCTION: The application of neurocognitive models to study schizophrenia has been influential in understanding the nature of this complex and heterogeneous disorder. However, a comprehensive and empirically validated account of auditory hallucinations remains elusive. The aim of this review was to critically assess the current evidence for specific neurocognitive deficits associated with auditory verbal hallucinations (AVHs) in schizophrenia. METHODS: A systematic literature search was conducted of research involving three influential cognitive models of auditory hallucinations: those implicating dysfunction in auditory imagery, verbal self-monitoring, and episodic memory. RESULTS: The findings of the review suggested that AVHs have been associated with impaired verbal self-monitoring, impaired memory for self-generated speech, heightened influence of top-down processing on perception, and an externalising response bias. CONCLUSIONS: On the basis of the findings of the review a multidimensional model of AVHs is proposed incorporating the identified cognitive deficits and biases.

Journal Article↗