Cases reported "Hallucinations"

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1/11. hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors.

    hallucinations, mainly of a visual nature, are considered to affect about one-quarter of patients with Parkinson's disease. They are commonly viewed as a side-effect of antiparkinsonian treatment, but other factors may be involved. The aim of this study was to determine the phenomenology, prevalence and risk factors of hallucinations in Parkinson's disease. Two-hundred and sixteen consecutive patients fulfilling clinical criteria for Parkinson's disease were studied. Demographic and clinical variables were recorded, including motor and cognitive status, depressive symptoms and sleep-wake disturbances. patients with and without hallucinations were compared using non-parametric tests, and logistic regression was applied to significant data. hallucinations had been present during the previous 3 months in 39.8% of the patients, and fell into three categories: minor forms, consisting of a sensation of a presence (person), a sideways passage (commonly of an animal) or illusions were present in 25.5% of the patients (an isolated occurrence in 14.3%), formed visual hallucinations were present in 22.2% (isolated in 9.3%) and auditory hallucinations were present in 9.7% (isolated in 2.3%). patients with minor hallucinations had a higher depression score than non-hallucinators but did not differ in other respects. Logistic regression analysis identified three factors independently predictive of formed visual hallucinations: severe cognitive disorders, daytime somnolence and a long duration of Parkinson's disease. These findings indicate that, when minor hallucinations are included, the total prevalence is much higher than previously reported. A simple side-effect of dopaminergic treatment is not sufficient to explain the occurrence of all visual hallucinations. The main risk factor in treated patients is cognitive impairment, although sleep-wake cycle disturbances, and possibly other factors related to the duration of the disease, act as cofactors.
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2/11. sleep and dream suppression following a lateral medullary infarct: a first-person account.

    consciousness can be studied only if subjective experience is documented and quantified, yet first-person accounts of the effects of brain injury on conscious experience are as rare as they are potentially useful. This report documents the alterations in waking, sleeping, and dreaming caused by a lateral medullary infarct. Total insomnia and the initial suppression of dreaming was followed by the gradual recovery of both functions. A visual hallucinosis during waking that was associated with the initial period of sleep and dream suppression is described in detail. Since the changes in sleep and their recovery are comparable to results of animal experiments, it can be concluded that damage to the medullary brain stem causes extreme but short-lived alterations in conscious state and that substantial recovery occurs even though the damage to the brain stem endures.
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3/11. Tactile hallucinations in Parkinson's disease.

    hallucinations occur in up to 40% of patients with Parkinson's disease (PD) and are mainly of a visual nature. We prospectively studied 8 patients with PD and tactile hallucinations (TH). TH occurred with a clear sensorium, and were long-lasting. In most cases they involved animals, were combined with other types of hallucinations occurring simultaneously (mainly formed visual hallucinations), and predominated in the evening and/or at night. Pharmacological and disease-related factors, including a disorder in rapid-eye-movement sleep mechanisms, could play a part in the pathophysiology of these hallucinations.
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4/11. Peduncular hallucinosis: unusual complication of cardiac catheterization.

    Peduncular hallucinosis (PH) is a rare form of visual hallucination characterized by vivid, nonstereotypical visual images of people, animals, and plants of brief duration that are nonthreatening to the patient. The clinical syndrome of PH consists of formed visual hallucinations, localizing signs of the offending lesion, and sleep disturbances. In the absence of localizing focal neurologic deficits, it is easily confused with a delirium or psychosis. It is seen with lesions involving the upper brainstem and diencephalon. The authors report a case of PH due to ischemic infarction of the midbrain after cardiac catheterization. Although PH has been reported after vertebral angiography, it has never been reported as a complication of cardiac catheterization.
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5/11. Visual hallucinations after acute visual loss in a young child.

    A four-year-old boy developed complex visual hallucinations consisting of moving figures, animals and other familiar objects one week after becoming totally blind. This followed a six-month period of gradually deteriorating vision and was precipitated by the debulking of a large optic nerve glioma. Although visual hallucinations are well recognised in adults with visual loss, secondary to both ophthalmological and neurological causes, they have not been reported in young children.
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6/11. The Dolittle phenomenon: hallucinatory voices from animals.

    Individuals with severe psychotic illnesses may experience hallucinatory voices from animals. Six cases are described, and the significance of such hallucinations is discussed. The term 'Dolittle phenomenon' is proposed.
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7/11. Multiple serial lycanthropy. A case report.

    A case is described who exhibited lycanthropy during an acute psychotic illness. During a short period she experienced herself as four different species of animal, an occurrence not previously reported. The phenomenon of lycanthropy is most appropriately regarded as a delusion, but the abnormal subjective experience is stressed, not just the falsely-held belief.
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8/11. Acute exacerbation of paranoid psychotic state after long-term abstinence in patients with previous methamphetamine psychosis.

    From a population of 111 patients with chronic methamphetamine (MAP) psychosis, who were treated at ten mental hospitals during the past 3 years, 21 patients were selected for study. Sixteen patients who experienced MAP psychosis again used MAP one or more times after long-term abstinence and experienced acute exacerbation of a paranoid psychotic state which was almost identical to the initial psychotic episode. Four of these patients relapsed following a single MAP reuse of an amount less than that initially used, and one relapsed without evidence of MAP reuse. In eight patients, small doses of neuroleptics, e.g., 3 mg per day of haloperidol, prevented the acute provocation of a psychotic state by MPA reuse. Subsequently, three of these relapsed into a psychotic state following MAP reuse without concurrent haloperidol medication. The clinical data were compared with animal experiments which indicate that chronic MAP use can induce a long-term susceptibility to sensitization to MAP. The positive prophylactic effect of small doses of haloperidol on the acute exacerbation may suggest the participation of dopaminergic supersensitivity as a mechanism for the paranoid psychotic state.
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9/11. reserpine withdrawal psychosis: the possible role of denervation supersensitivity of receptors.

    A case is reported in which abrupt cessation of long term reserpine therapy for hypertension was followed by hallucinations and mania. reserpine is thought to induce a denervation sensitivity to dopamine in the basal ganglia and chemotactic trigger zone in man and to catecholaminergic agents in the basal ganglia and mesolimbic system in animals. Conceivably, a parallel supersensitivity in the mesolimbic area could have occurred in this patient and accounted for the psychiatric symptoms. This supersensitivity and the possibility that it may, like tardive dyskinesia, be persistent should be considered when reserpine or similar drugs are used for prolonged periods.
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10/11. Complex visual hallucinations in partial blindness due to eye disease.

    Three patients experienced complex formed hallucinations during progressive visual failure from eye disease. The hallucinations began abruptly, were brightly coloured stereotyped figures, animals or objects, and appeared to be provoked by light. As blindness progressed the clarity, frequency and duration of the hallucinations faded. The patients had no abnormalities other than their eye disease, which in two cases was macula degeneration, and choroideraemia in the third.
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