Phenomenology of visual hallucinations in psychiatric conditions.
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A teenage male is described, in whom Tourette Syndrome was suspected, which was later replaced by attacks of paroxysmal kinesigenic choreo-athetosis. He also exhibited bizarre, episodic perceptual distortions of his visual environment and manifestations of an obsessive-compulsive disorder. Carbamazepine treatment not only completely eliminated the recurring attacks of his choreo-athetosis but also, contrary to expectations, the visual disturbances and even the symptoms of his obsessive-compulsive disorder. Obsessive compulsive disorder should be searched for by direct questioning in all patients with basal ganglia disorders.
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PURPOSE: We describe a patient with complex partial seizure with unidirectional olfactory aura associated with ipsilateral unruptured aneurysm. METHODS AND RESULTS: The patient felt a sweet pleasant smell coming from behind her right side every time before the attack. Cranial magnetic resonance imaging (MRI) and three-dimensional computed tomography (CT) angiography revealed a large aneurysm at the bifurcation of the right middle cerebral artery and compression of the right orbitofrontal cortex. Small spikes were recorded from the right orbitofrontal and superior temporal gyri and from the uncus by the cortical electrodes during clipping of the aneurysm. CONCLUSIONS: The orbitofrontal cortex may have a function related to the ipsilateral directional olfactory sensation.
Widowed residents of two nursing homes who were oriented to person, time, and place were interviewed to determine the extent to which they had hallucinatory experiences of their deceased spouse. Fifty-two interviews were completed with 46 widows and six widowers. Results are reported for the widows. Twenty-eight (61%) of the widows reported hallucinatory experiences of their deceased spouse. Twenty-four (86%) of the widows described the experiences as good or helpful. Thirteen (46%) reported that the experiences continue to happen. Nineteen (54%) of the widows had never discussed the experiences with anyone before this study. These results are surprisingly similar to previously published findings by Rees in Wales and suggest that these experiences are more common in the United States than has been recognized.
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