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At least 793 records · Page 44Linked to original sources
PubMed2005

Visual hallucinations in the diagnosis of idiopathic Parkinson's disease: a retrospective autopsy study.

BACKGROUND: For many years, visual hallucinations (VH) in idiopathic Parkinson's disease (PD) were thought to be a complication of antiparkinsonian treatment. The cause of VH is now thought to be nerve-cell loss and Lewy-body pathology in the ventral-temporal regions of the brain. However, the use of VH as a clinical sign of PD has not been investigated. METHODS: 788 cases with parkinsonism archived at the Queen Square Brain Bank for Neurological Diseases were identified for study. Patients had not been given standardised antemortem assessments. Clinical records were assessed for reports of VH. The incidence of VH in pathologically diagnosed cases was calculated, and factors affecting onset of VH were investigated. FINDINGS: VH occurred in 50% (221/445) of patients with PD, in 73% (32/44) with dementia with Lewy bodies (DLB), and in only 7% (18/255) of patients with non-Lewy-body parkinsonism. The specificity of VH for Lewy-body parkinsonism (PD and DLB combined) was 92.9% (95% CI 89.1-95.8) and the positive predictive value was 93.4% (89.7-95.8). VH were associated with cognitive dysfunction (hazard ratio 5.62, 3.37-9.35), autonomic dysfunction (3.13, 1.77-5.52), axial rigidity (2.22, 1.26-3.85) within the first 2 years of disease onset and also age of onset (1.05, 1.03-1.07). In PD, the onset of VH typically occurred in the second half of the disease course, and time to onset of VH was only weakly correlated with use of selegiline (Spearman's rho 0.22, p=0.005) and ergot dopamine agonists (0.24, p=0.006) but not correlated with use of levodopa, amantadine, or anticholinergic drugs. INTERPRETATION: The presence of VH is helpful in the differentiation of PD from other non-Lewy-body causes of parkinsonism. We propose that VH be added, as a supportive criterion, to the operational clinical criteria for the diagnosis of PD.

Adult↗
PubMed2004

Hallucination focused integrative treatment improves quality of life in schizophrenia patients.

OBJECTIVE: Psychosocial treatment seems to be effective in the management of schizophrenia, although less in the area of quality of life and social functioning. To study the effectiveness of a hallucination focused integrated treatment with cognitive-behaviour therapy and coping training among schizophrenia patients suffering from 'hearing voices'. METHOD: In a randomized controlled trial (RCT) with 31 patients in the integrated treatment condition and 32 patients in the routine care condition, quality of life was assessed with the self-report questionnaire of the WHO (Bref), and social role functioning with an interviewer based schedule, at entry and 9 (post-treatment) and 18 months later. RESULTS: Follow-up data suggest a significant improvement of quality of life and in particular in social role functioning (effect size 0.64) in favour of the integrated treatment. CONCLUSION: The integrated treatment seems to be effective in reducing overall disability levels and number of patients with serious disabilities.

Adaptation, Psychological↗
PubMed2003

Sexual hallucinations during and after sedation and anaesthesia.

Sexual hallucinations have been reported since the introduction of chloroform. Newer agents such as midazolam and propofol appear particularly prone to producing them. Some practitioners have been the victims of allegations resulting from the hallucinogenic effects of these drugs. Other individuals, including doctors, have used the amnesic effects of midazolam and other drugs to sexually assault victims. Clinicians should be aware of the risks to which they may inadvertently expose themselves if these drugs are not used carefully.

Adolescent↗
PubMed1998

Visual hallucinations and macular degeneration: an example of the Charles Bonnet syndrome.

PURPOSE: Patients with any form of visual disturbance, no matter how unusual, often present first to their ophthalmologist. An example of the Charles Bonnet syndrome as a result of bilateral macular degeneration is presented. The significance of early diagnosis is highlighted as reassurance and explanation of the condition seems to be the cornerstone of management. METHODS/RESULTS: A chronological case history, results of investigations and management are presented. CONCLUSIONS: The diagnosis of Charles Bonnet syndrome should be considered in elderly, cognitively intact patients who present with vivid, elaborate and complex visual hallucinations following ocular pathology. Although there is no universal definition of this entity and there is no specific pharmacotherapy, patients may be referred for counselling.

Antidepressive Agents↗
PubMed1996

Meningeal hyperperfusion visualized by MRI in a patient with visual hallucinations and migraine.

A 41-year-old patient with a history of migraine but with no history of seizures had intermittent prolonged and variable complex visual hallucinations and illusions lasting 9 days, accompanied by unilateral headache. Electroencephalography during these visual symptoms revealed occipital epileptic discharges. Distinction between focal migrainous attacks and ictal phenomena was difficult. Magnetic resonance imaging showed a lesion in the right visual cortex probably related to low perfusion and hyperemia of meningeal vessels, representing the rarely described transient MRI changes associated with migraine. Continued treatment with antiepileptic drugs and calcium-channel blocking agents completely resolved the headache and visual symptoms, while minor EEG changes persisted. After discontinuation of treatment, a second attack occurred with a similar and reversible pattern on EEG.

Adult↗
PubMed2000

Ictal visual hallucinations and post-ictal hemianopia with anosognosia.

We report the case history of an adult who developed seizures with nearly pure visual symptoms due to an occipital vascular lesion. The seizures were characterized by elementary visual hallucinations in the right visual field. Interictally, a dense homonymous hemianopia was demonstrated in the clinical examination and by using perimetry, but was not recognized by the patient himself. The seizures vanished and the visual fields normalized completely after initiation of anticonvulsive treatment.

Aged↗
PubMed2000

Visual perceptual abnormalities: hallucinations and illusions.

Visual perceptual abnormalities may be caused by diverse etiologies which span the fields of psychiatry and neurology. This article reviews the differential diagnosis of visual perceptual abnormalities from both a neurological and a psychiatric perspective. Psychiatric etiologies include mania, depression, substance dependence, and schizophrenia. Common neurological causes include migraine, epilepsy, delirium, dementia, tumor, and stroke. The phenomena of palinopsia, oscillopsia, dysmetropsia, and polyopia among others are also reviewed. A systematic approach to the many causes of illusions and hallucinations may help to achieve an accurate diagnosis, and a more focused evaluation and treatment plan for patients who develop visual perceptual abnormalities. This article provides the practicing neurologist with a practical understanding and approach to patients with these clinical symptoms.

Hallucinations↗
PubMed2006

Association of auditory hallucinations and anticonvulsant hypersensitivity syndrome with carbamazepine treatment. A case report.

Carbamazepine is effective in the treatment of acute mania and in the prevention of episodes in bipolar disorder, and it may also be useful in depression, impulse-control disorder and withdrawal from alcohol and benzodiazepine dependence. A potentially life-threatening side effect is the anticonvulsant hypersensitivity syndrome. Here, we describe a patient who developed severe auditory hallucinations followed by a distinct hypersensitivity syndrome most likely induced by carbamazepine treatment.

Anticonvulsants↗
PubMed1998

[Chronic visual hallucinations and illusions following brain lesions. A single case study].

Lesions of the visual system do not necessarily lead to deficits in visual function. In some cases, there may even occur Positive Spontaneous Visual Phenomena (PSVP) following cerebral damage. We present data from a male patient with continuous, long-term visual illusions after having experienced cerebral infarction at the age of 56. Basing on conventional Magnetic Resonance Imaging, lesions could be located in areas supported by the lateral and medial occipital artery. Initially, homonymous hemianopsia of the right visual field was found in perimetric examinations, but in the course of six months, visual function recovered completely. Ever since the incident, the patient has been suffering from permanent photopsia, intense colourful visual hallucinations and perseverations located in the former defective area which continued unabated even after the remission of his visual field defects. While many authors have published data on PSVP lasting for several seconds, usually vanishing completely within days or weeks after cerebral lesion, in our patient the symptoms continued over a period of so far nine months. Surprisingly, he was even able to make drawings of his illusions so that we were able to include some of his pictures.

Cerebral Infarction↗
PubMed1998

[Hypnogogic hallucinations of macrosomatognosia and microsomatognosia].

Macrosomatognosia and microsomatognosia, in which the entire body or parts of the body are perceived as abnormally large or small, can occur as hypnagogic hallucinations in sane and healthy subjects. A review of the literature and five original observations are presented. The mouth and the hands are anatomic regions which are frequently affected, paralleling the dominance of their representation in the sensory maps of the human brain. The clinical differential diagnosis of the said phenomena includes narcolepsy, epileptic and migraine aura, drug-induced body schema disturbances and basic symptoms of functional psychoses.

Adult↗
PubMed2003

Negative and positive visual hypnotic hallucinations: attending inside and out.

Hypnotic perceptual alteration affects brain function. Those hypnotic instructions that reduce perception by creating an illusory obstruction to it reduce brain response to perception in the cognate sensory cortex, as measured by event-related potential (ERP) amplitude and regional blood flow (PET). Those hypnotic instructions that affect the subject's reaction to perception activate the anterior attentional system, especially the anterior cingulate cortex in PET studies. Hypnosis involves activation without arousal and may be particularly mediated via dopaminergic pathways. Hypnotic alteration of perception is accompanied by measurable changes in both perceptual and attentional function of those specific regions of the brain that process these activities, modulated by the nature of the specific hypnotic instruction. Positive obstructive hallucinations seem to allow for a hypnotic focus inward, activating the functioning of attentional neural systems and reducing perceptual ones.

Affect↗
PubMed1998

Surreptitious observation of responses to hypnotically suggested hallucinations: a test of the compliance hypothesis.

Suggestions for arm levitation and for visual, auditory, tactile, and taste hallucinations were administered twice via audiotape to a group of high suggestible students and low suggestible simulators. During one of the administrations, participants were led to believe they were alone, but their behavior was surreptitiously recorded on videotape and observed on a video monitor. During the other administration, they were observed openly by an experimenter who had not been informed about group assignment. When unaware that they were being observed, simulators were significantly less responsive to suggestion and engaged in substantially more role-inappropriate behavior. In contrast, the responsiveness of nonsimulating students was not affected by the presence of an experimenter, and they exhibited little role-inappropriate behavior even when alone. These data indicate that the responses of suggestible individuals reflect internally generated changes in experience and are not due to simple intentional compliance (i.e., faking).

Adult↗
PubMed1985

Auditory hallucinations in nonverbal quadriplegics.

When a system for communicating with nonverbal, quadriplegic, institutionalized residents was developed, it was discovered that many were experiencing auditory hallucinations. Nine cases are presented in this study. The "voices" described have many similar characteristics, the primary one being that they give authoritarian commands that tell the residents how to behave and to which the residents feel compelled to respond. Both the relationship of this phenomenon to the theoretical work of Julian Jaynes and its effect on the lives of the residents are discussed.

Adult↗
PubMed1996

Nightmares and hallucinations after long-term intake of tramadol combined with antidepressants.

Tramadol is a weak opioid with effects on adrenergic and serotonergic neurotransmission that is used to treat cancer pain and chronic non malignant pain. This drug was initiated in association with paroxetine and dosulepine hydrochloride in a tetraparetic patient with chronic pain. Fifty-six days after initiation of the treatment the patient presented hallucinations that only stopped after the withdrawal of psycho-active drugs and tramadol. The case report questions the long term use of pain killers combined with psycho-active drugs in chronic non malignant pain, especially if pain is under control.

Aged↗
PubMed2004

Correlates of the affective impact of auditory hallucinations in psychotic disorders.

While many who hear auditory hallucinations (AHs) experience them as unpleasant, some do not. Little is known about the correlates of AHs that are not unpleasant, or of the characteristics of those who hear them. To better understand this symptom, we used a comprehensive structured interview schedule to study 199 subjects who had experienced AHs. Subjects' responses to AHs were combined into two indexes: one assessing total affective impact and the other assessing the affective direction (positive or negative). Subjects who had grandiose delusions experienced their AHs more positively. AHs that were more frequent, lasted longer, and were louder were experienced more negatively. AHs heard in the second person and those related to people with whom the subjects had personal relationships were more positive than those heard in the third person. Many other aspects of AHs were unrelated to total affective impact or direction. It is argued that the positive evaluation of voices by subjects requires greater attention than it has received previously. Implications for assessment, clinical practice, and research are discussed.

Adolescent↗
PubMed2000

Theta rhythm increases in left superior temporal cortex during auditory hallucinations in schizophrenia: a case report.

Auditory hallucinations (AH), the perception of sounds and voices in the absence of external stimuli, remain a serious problem for a large subgroup of patients with schizophrenia. Functional imaging of brain activity associated with AH is difficult, since the target event is involuntary and its timing cannot be predicted. Prior efforts to image the patterns of cortical activity during AH have yielded conflicting results. In this study, MEG was used to directly image the brain electrophysiological events associated with AH in schizophrenia. We observed an increase in theta rhythm, as sporadic bursts, in the left superior temporal area during the AH states, whereas there was steady theta band activity in the resting state. The present finding suggests strong association of the left superior temporal cortex with the experience of AH in this patient. This is consistent with the hypothesis that AH arises from areas of auditory cortex subserving receptive language processing.

Adult↗
PubMed1993

Brain SPECT in a patient with post-stroke hallucination.

A patient developed visual hallucinations following a left-sided cerebrovascular accident (CVA). Brain SPECT using Tc-99m HMPAO demonstrated increased perfusion at the biparieto-occipital lobes. Following antiepileptic medication, repeat brain SPECT showed interval decrease in perfusion in the same areas with the symptomatic relief of hallucinatory episode. While it is possible that the interval decrease is due to natural resolution, the authors believe that it is likely due to drug treatment.

Aged↗