scholarly journals Cerebellar correlates of visual hallucinations in Parkinson's disease and Charles Bonnet Syndrome

Cortex ◽  
2020 ◽  
Author(s):  
Timothy Lawn ◽  
Dominic ffytche
2022 ◽  
Vol 12 ◽  
Author(s):  
Adam Fry ◽  
Dharampreet Singh ◽  
Louis Manganas ◽  
Marc L. Gordon ◽  
Christopher Christodoulou ◽  
...  

Background: Visual hallucinations (VHs) in Parkinson's disease (PD) are the cardinal symptoms which declare the onset of PD psychosis (PDP). The anthropomorphic and zoomorphic VHs of PD resemble those of Charles Bonnet syndrome and temporal lobe epilepsy. In both of these disorders electroencephalography (EEG) abnormalities have been described. We therefore sought to examine whether VHs in PD were associated with similar EEG abnormalities.Methods: This retrospective observational study searched the medical records of 300 PD patients and filtered for those containing clinical 20-min scalp EEGs. Remaining records were separated into two groups: patients with reported VHs and those without. The prevalence of epileptiform discharges in the EEGs of both groups was identified.Results: Epileptiform discharges were present in 5 of 13 (38.5%) PD patients with VHs; all localized to the temporal lobe. No epileptiform discharges were observed in the EEGs of the 31 PD patients without VHs.Conclusion: The significantly high incidence of temporal lobe epileptiform discharges in PD patients with VHs as compared to those without VHs lends to the possibility of an association visual cortex epileptogenic focus. Accordingly, for treatment-refractory patients, antiepileptic drugs might be considered, as in the case of Charles Bonnet syndrome, temporal lobe epilepsy and migraine with visual aura. Future prospective studies involving larger samples and multi-center cohorts are required to validate these observational findings.


2021 ◽  
pp. practneurol-2021-003016
Author(s):  
Rimona S Weil ◽  
A J Lees

Visual hallucinations have intrigued neurologists and physicians for generations due to patients’ vivid and fascinating descriptions. They are most commonly associated with Parkinson’s disease and dementia with Lewy bodies, but also occur in people with visual loss, where they are known as Charles Bonnet syndrome. More rarely, they can develop in other neurological conditions, such as thalamic or midbrain lesions, when they are known as peduncular hallucinosis. This review considers the mechanisms underlying visual hallucinations across diagnoses, including visual loss, network dysfunction across the brain and changes in neurotransmitters. We propose a framework to explain why visual hallucinations occur most commonly in Parkinson’s disease and dementia with Lewy bodies, and discuss treatment approaches to visual hallucinations in these conditions.


2006 ◽  
Vol 21 (11) ◽  
pp. 1899-1907 ◽  
Author(s):  
David Burn ◽  
Murat Emre ◽  
Ian McKeith ◽  
Peter Paul De Deyn ◽  
Dag Aarsland ◽  
...  

1995 ◽  
Vol 167 (4) ◽  
pp. 522-526 ◽  
Author(s):  
John D. C. Mellers ◽  
Niall P. Quinn ◽  
Maria A. Ron

BackgroundThe growth hormone (GH) response to apomorphine, thought to reflect central dopaminergic receptor sensitivity, has been reported as enhanced in acute schizophrenia. We investigated this response in relation to the psychotic episodes associated with Parkinson's disease (PD).MethodThe GH response to apomorphine was measured in three groups of patients with Parkinson's disease: those currently psychotic (n = 9), those with a past history of psychosis (n = 7) and those who had never been psychotic (n = 8).ResultsApomorphine-induced GH response was not related to psychosis but was unexpectedly associated with measures of depression.ConclusionsVisual hallucinations were a prominent feature in the psychotic patients and the atypical nature of these psychoses might explain why we found no evidence of dopaminergic sensitivity. Serotonergic dysfunction would be in keeping with this. Dopaminergic mechanisms may contribute to the minor depressive symptomatology seen in PD.


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