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PubMed1992

Violent visual hallucinations and aggression in frontal lobe dysfunction: clinical manifestations of deep orbitofrontal foci.

Three patients from different racial, social, and economic backgrounds were studied because of sudden intrusive thoughts: visions or intrusions of threatening scenes--violent, aggressive, and sometimes horrifying--that lasted from seconds to minutes. Apart from the association with intense anxiety, fear, and aggression, there was no association with oculomotor, motor, sensory, or autonomic dysfunction or altered conscious state. Patients had abnormal intermittent discharges that arose from frontal areas and probably did not spread further. Carbamazepine was useful in two cases. The authors suggest that violent, brief hallucinations with no other epileptic sign may be manifestations of frontal lobe seizures.

Adult↗
PubMed1997

Depression, delusions, and hallucinations in Alzheimer's disease: no relationship to apolipoprotein E genotype.

The apolipoprotein E (APOE) locus on chromosome 19 has been shown to modify risk, and age at onset, of Alzheimer's disease (AD). The authors hypothesized that the phenotypic expression of different psychiatric symptoms in patients with AD would be associated with variability in APOE locus. Neuropsychiatric and genetic testing of 120 probable AD patients revealed 28% had major depression, 17% had minor depression, 30% had delusions, and 14% had hallucinations; 69% were carriers of at least one APOE E4 allele (14% homozygous E4/E4, 49% heterozygous E3/E4, 6% heterozygous E2/E4, 29% homozygous E3/E3, 2% heterozygous E2/E3). Prevalence of the various psychiatric disturbances did not differ significantly in AD patients with different APOE genotypes. Apolipoprotein E does not appear to modify the risk of developing AD-associated psychiatric symptomatology.

Aged↗
PubMed2001

Visual hallucination and tremor induced by sertraline and oxycodone in a bone marrow transplant patient.

The authors report a case of probable serotonin syndrome caused by the coadministration of sertraline and oxycodone. A 34 year-old male patient experienced visual hallucinations and severe tremor after dramatically increasing his dosage of oxycodone while on stable amounts of sertraline and cyclosporin. Discontinuation of cyclosporin did not result in resolution of his symptoms. Consideration of a possible sertraline-oxycodone interaction led to withholding sertraline, which resulted in symptom resolution. Serotonin syndrome has been noted with sertraline in combination with other drugs, but this is the first report in combination with a narcotic analgesic. Possible pharmacological mechanisms are discussed. In complicated patients that are taking multiple medications, physicians should be aware of this possible interaction to avoid delay in the diagnosis of serotonin syndrome.

Adult↗
PubMed2000

Hypnopompic hallucinations with donepezil.

A case of hypnopompic hallucinations associated with donepezil is described. Electroencephalogram (EEG) and sleep EEG changes are common in Alzheimers Disease and acetylcholinesterase inhibitor drugs can affect rapid eye movement sleep and alertness. The importance of assessing sleep in patients treated with these drugs is discussed.

Alzheimer Disease↗
PubMed1987

A case of Charles Bonnet syndrome with musical hallucinations.

An 86-year-old woman with visual impairment who developed a vivid, visual hallucinatory state in clear sensorium is described. This picture conforms to the description of Charles Bonnet Syndrome. She also experienced musical hallucinations. The role of sensory deprivation in the pathogenesis of this syndrome is discussed.

Aged↗
PubMed1990

A case study: schizophrenia and tactile hallucinations, treated with electroconvulsive therapy.

The authors review the literature on tactile hallucinations. They examine its occurrence in a schizophrenic patient who had poor response to neuroleptic medication, after several admissions to a psychiatric hospital. The patient responded well to electroconvulsive therapy when it was combined with a small dose of a neuroleptic. Due to prolonged use of neuroleptics he developed tardive dyskinesia that responded only to a large dose of lecithin. They discuss the use of electroconvulsive therapy in schizophrenic patients who have shown little or no response to neuroleptics after prolonged use. The case presented showed better clinical response with smaller doses of antipsychotic medication, when combined with electroconvulsive therapy.

Adult↗
PubMed2002

Recurrent attacks of fear and visual hallucinations in a child.

The case of a 7-year-old boy suffering from recurrent nocturnal and occasional daytime attacks with intense fear and complex visual hallucinations is presented. His state was otherwise normal, as were routine electroencephalographic (EEG) and magnetic resonance imaging (MRI) investigations in the past. Several differential diagnoses such as panic disorder, pavor nocturnus, and nightmares were considered but could not be definitely established or excluded. Since the attacks appeared after the divorce of his parents, an adjustment disorder was suspected, and the patient received psychotherapy for more than 2 years without an effect on the attacks. Only when long-term video-EEG recorded two typical attacks with left temporal ictal seizure patterns was focal epilepsy diagnosed and successfully treated with antiepileptic medication. A suspected origin of seizures in the amygdala was supported by a high-resolution MRI showing a cortical dysplasia extending from the left anteromedial temporal lobe to the amygdala. The case exemplifies difficulties in the differential diagnosis of panic-like attacks and underlines the value of long-term video-EEG, which may be necessary to establish the correct diagnosis and to prevent ineffective therapeutical approaches.

Amygdala↗
PubMed1985

Hallucinations after preoperative baclofen discontinuation in spinal cord injury patients.

Baclofen is a muscle relaxant approved in this country for the treatment of muscle spasms secondary to multiple sclerosis, spinal cord injury, and other spinal diseases. Although baclofen is considered to have fewer side effects than alternative drugs, problems can occur when the dosage is changed abruptly. Two patients are presented who developed hallucinations after discontinuing baclofen as part of routine preoperative procedures. Both patients responded at 23 and 31 hours after reinstituting baclofen. If possible, patients should be withdrawn slowly from baclofen before surgery. Any patient withdrawn abruptly from baclofen should be restarted as soon as possible.

Adult↗
PubMed1989

Hostility and hallucinations as a consequence of midazolam administration.

A 74-year-old woman experienced an apparent psychotic reaction several hours after administration of iv midazolam as a premedicant for gastroscopy. The reaction included confusion, hallucinations, and hostility and required administration of haloperidol to calm her. The woman subsequently underwent colonoscopy with meperidine as a premedication and experienced no behavioral changes. Although other causes cannot be completely ruled out, the evidence points strongly to midazolam as the precipitating agent for the psychotic reaction.

Aged↗
PubMed1981

The effects of varying auditory input on schizophrenic hallucinations.

The present report is of the effect of variations of auditory input on hallucinatory experiences in seven schizophrenic patients. Nine experimental conditions, each of two minutes' duration were compared with a control condition. At the end of each period subjects were required to rate the duration, loudness, and clarity of hallucinations during that time. Experimental conditions varied according to the amount of structure present in the material and in its attention-commanding properties. One condition required the active monitoring of material presented and resulted in the greatest decrease in hallucinatory experiences. For the passive conditions, findings were broadly consistent with predictions, indicating that it is not stimulation per se, but rather the extent to which structure is present and attended to, that is important in determining the occurrence of hallucinatory phenomena.

Acoustic Stimulation↗
PubMed1983

The relationship between auditory hallucinations and spontaneous fluctuations of skin conductance in schizophrenia.

A sample was collected of schizophrenic patients exhibiting nonverbal signs of intermittent auditory hallucinations. A video-tape record was made for each of a session, during which the patient's skin conductance was monitored. Independent raters achieved reasonable agreement on the onset of periods of hallucinatory activity, as judged from non-verbal signs. The skin conductance tracing was scored independently for spontaneous fluctuations. In the 10 patients with satisfactory records the onset of hallucinatory periods was significantly (P less than 0.01) associated with a rise in the spontaneous fluctuation rate.

Adult↗
PubMed1989

Transient recurrence of auditory hallucinations during acute dystonia.

Three schizophrenic patients who had transient recurrence of auditory hallucinations during acute dystonia precipitated by neuroleptic medication are reported. If it is accepted that psychotic symptoms result from dopaminergic overactivity, such phenomena suggest that acute dystonia might also have been caused by increased dopaminergic neurotransmission in these cases.

Adolescent↗
PubMed2002

Independent course of childhood auditory hallucinations: a sequential 3-year follow-up study.

BACKGROUND: Childhood hallucinations of voices occur in a variety of contexts and have variable long-term outcomes. AIM: To study the course of experience of voices sequentially over a 3-year period in those with and those without a need for mental health care (patient status). METHOD: In a group of 80 children of mean age 12.9 years (s.d. = 3.1), of which around 50% were not receiving mental health care, baseline measurement of voice characteristics, voice attributions, psychopathology, stressful life events, coping mechanisms and receipt of professional care were used to predict 3-year course and patient status. RESULTS: The rate of voice discontinuation over the 3-year period was 60%. Patient status was associated with more perceived influence on behaviour and feelings and more negative affective appraisals in relation to the voices. Predictors of persistence of voices were severity and frequency of the voices, associated anxiety/depression and lack of clear triggers in time and place. CONCLUSIONS: Need for care in the context of experience of voices is associated with appraisal of the voices in terms of intrusiveness and 'omnipotence'. Persistence of voices is related to voice appraisals, suggesting that experience of voices by children should be the target of specific interventions.

Adolescent↗
PubMed2004

ApoE epsilon4 allele is associated with incidental hallucinations and delusions in patients with AD.

Of 135 patients with Alzheimer disease (AD), 56 without psychiatric symptoms at the first visit were followed for a mean period of 51.9 +/- 10.3 months to identify incident psychiatric symptoms. The hazard ratios of ApoE epsilon4 allele in developing psychiatric symptoms were calculated by Cox regression hazard analyses. The presence of the ApoE epsilon4 allele carried a 19.0-fold risk for developing hallucinations and a 3.4-fold risk for delusions.

Aged↗
PubMed1984

Ictal visual hallucinations of numerals.

We studied three children with benign primary occipital epilepsy who had ictal numerical visual hallucinations. This unusual ictal event may occur in patients with left-sided, right-sided, or bilateral interictal spikes, and such attacks may begin in either occipital lobe. This event seems to be occipital, without limbic participation, although the ictal discharge may spread to limbic structures as the seizure evolves.

Child↗
PubMed2004

Hallucinations and sleep disturbances in Parkinson's disease.

Visual hallucinations (VHs) occur frequently in Parkinson's disease (PD). VHs occur more frequently in elderly patients with longer duration of illness, cognitive impairment, and sleep disturbances. The relationship between the use of antiparkinsonian drugs and VHs is complicated, but most drugs used to treat parkinsonian motor symptoms induce VHs and psychosis in some PD patients. The "continuum hypothesis" proposing that medication-induced psychiatric symptoms in PD begin with drug-induced sleep disturbances, followed by vivid dreams, with progression to hallucinatory and delusional experiences has been challenged. In some patients, VHs may represent intrusion of REM sleep-related imagery into wakefulness. Improving REM sleep abnormalities in PD (e.g., stimulants, anticholinesterase inhibitors) is one strategy now being tested to improve VHs in PD.

Antiparkinson Agents↗
PubMedDate not supplied

Awareness, dreams, and hallucinations associated with general anesthesia.

This incidence of mental aberrations (awareness, dreams, and hallucinations) in 490 adult patients undergoing a variety of surgical procedures was investigated. The total incidence of mental aberrations reported was 11 percent (awareness 1 percent, halluncinations 2 percent, dreams 8 percent). No statistically significant correlation was found between the incidence of unusual mental reactions and the anesthetic agents employed, the age or sex of the patients, or the duration or type of surgical prcedure.

Adolescent↗