An older man with visual hallucinations, tremor, and gait dysfunction

Background and Objective: Charles Bonnet Syndrome (CBS) has been defined as complex visual hallucinations (CVH) due to visual loss. The underlying mechanism of CBS is not clear and the underlying pathophysiology of the visual hallucinations in CBS patients and pure visually impaired patients is still not clear. </P><P> Methods: In our study, we have scanned three patients with eye disease and CBS (VH+) and three patients with eye disease without CBS (VH-) using FDG-PET. Results: Our results showed underactivity in the pons and overactivity in primary right left visual cortex and inferior parietal cortex in VH- patients and underactivity in left Broca, left inf frontal primary visual cortex and anterior and posterior cingulate cortex in VH+ patients relative to the normative 18FFDG PET data that was taken from the database consisting of 50 age-matched healthy adults without neuropsychiatric disorders. Conclusion: From this distributed pattern of activity changes, we conclude that the generation of visual hallucination in CBS is associated with bottom-up and top-down mechanism rather than the generally accepted visual deafferentation-related hyperexcitability theory.

Download Full-text

Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment

BMJ Case Reports ◽

10.1136/bcr-2019-233179 ◽

2020 ◽

Vol 13 (12) ◽

pp. e233179

Author(s):

Eric Garrels ◽

Fawziya Huq ◽

Gavin McKay

Keyword(s):

Cognitive Impairment ◽

Case Report ◽

Potassium Channel ◽

Limbic Encephalitis ◽

Psychiatric Symptoms ◽

Differential Diagnoses ◽

Visual Hallucinations ◽

Voltage Gated ◽

History Of ◽

Impaired Cognition

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

Download Full-text

Imagine that: cholinesterase inhibitor treatment of complex visual hallucinations of unknown aetiology

Cognitive Neuropsychiatry ◽

10.1080/13546805.2021.1941832 ◽

2021 ◽

pp. 1-8

Author(s):

Y. Salih ◽

A. De Angelis ◽

N. A. Poole

Keyword(s):

Cholinesterase Inhibitor ◽

Visual Hallucinations ◽

Unknown Aetiology ◽

Inhibitor Treatment

Download Full-text

Factors affecting hallucinations in patients with delirium

Scientific Reports ◽

10.1038/s41598-021-92578-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Masako Tachibana ◽

Toshiya Inada ◽

Masaru Ichida ◽

Norio Ozaki

Keyword(s):

Rating Scale ◽

Detailed Examination ◽

Individual Factors ◽

Visual Hallucinations ◽

Angiotensin Ii Receptor ◽

Contributing Factors ◽

Factors Affecting ◽

Receptor Blockers ◽

Benzodiazepine Withdrawal ◽

Exogenous Substances

AbstractDelirium develops through a multifactorial process and include multiple subtypes with different pathological factors. To refine the treatment and care for delirium, a more detailed examination of these subtypes is needed. Therefore, this study aimed to explore the factors affecting delirium in cases in which hallucinations are conspicuous. In total, 602 delirium cases referred to the psychiatry department at a general hospital between May 2015 and August 2020 were enrolled. The Delirium Rating Scale-revised-98 was used to assess perceptual disturbances and hallucinations in patients with delirium. Multiple regression analysis was applied to determine whether individual factors were associated with the hallucinations. A total of 156 patients with delirium (25.9%) experienced hallucinations, with visual hallucinations being the most common subtype. Alcohol drinking (p < 0.0005), benzodiazepine withdrawal (p = 0.004), and the use of angiotensin II receptor blockers (p = 0.007) or dopamine receptor agonists (p = 0.014) were found to be significantly associated with hallucinations in patients with delirium. The four factors detected in this study could all be reversible contributing factors derived from the use of or withdrawal from exogenous substances.

Download Full-text

Prevalence of Hallucinations in the General Croatian Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084237 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4237

Author(s):

Jelinčić Ivana ◽

Degmečić Dunja

Keyword(s):

General Population ◽

Clinical Significance ◽

Assessment Tool ◽

Visual Hallucinations ◽

The World ◽

The Mind

Background: Hallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind. However, little is known about the distribution of incident hallucinations in the community. This paper aims to examine manifestation and frequency of the hallucinatory experiences within the general Croatian population. Methods: The instrument of the survey is Chicago Hallucination Assessment Tool (CHAT). The study included 521 examinees; 284 females (54.5%) and males 237 (45.5%). Results: There was a manifestation of all types of hallucinatory experiences determined. Out of all of the participants 17% listed that they experienced acoustic hallucinations during their lifetime, 15% said that they have experienced visual hallucinations, 12% olfactory hallucinations, 10% gustatory and 12% tactile/cenesthetic hallucinations. Conclusion: The results of this research have indicated that simple hallucinations were mostly represented among the general Croatian population and those more complex were represented less which is a positive thing because of its prominent clinical significance. The contribution of this study is the possibility of comparisons with studies from different regions of Europe and the world. This is another component in a better understanding of the incidence of hallucinations in the general population. The data we have obtained puts us on the map of countries trying to raise awareness of a topic that needs to acquire more attention.

Download Full-text