Cases reported "Illusions"

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1/30. Posthallucinogen-like visual illusions (palinopsia) with risperidone in a patient without previous hallucinogen exposure: possible relation to serotonin 5HT2a receptor blockade.

    BACKGROUND: Previous reports document visual illusions resembling hallucinogen persisting perception disorder (HPPD) after risperidone treatment in patients with histories of previous LSD exposure. methods: We report a case with visual disturbances resembling HPPD after each of three consecutive risperidone dose increases. RESULTS: Contrasting with previous reports, our patient lacked any history of substance abuse, particularly hallucinogen exposure. She lacked neurologic or other contributory illnesses. illusions generally remitted within 48 hours each time. Coadministration of trazodone and clonazepam may have contributed to these phenomena, although clonazepam has been used to treat this condition. She had been unusually sensitive to the side-effects of many psychotropics. CONCLUSIONS: This case is unique due to the absence of substance abuse. This and another report note heightened sensitivity to medication side-effects. Visual phenomena resembling HPPD evidently can occur with risperidone and, possibly, other atypical antipsychotics and certain antidepressants regardless of previous hallucinogen use. Several lines of evidence implicate reduced 5HT2a serotonin receptor stimulation rather than increased 5HT2c stimulation.
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2/30. Doing it with mirrors: a case study of a novel approach to neurorehabilitation.

    arm amputees can experience the perception of movement of a phantom limb while looking at a mirror reflection of the moving, intact arm superimposed on the perceived phantom. Such use of a mirror to provide illusory visual feedback of movement can be useful in rehabilitation of hemiparetic patients. In this case report, we describe the successful application of "mirror therapy" to the post-stroke rehabilitation of a patient with poor functional use of an upper extremity, due mainly to somatosensory deficits. Mirror therapy facilitated employment of a motor copy strategy (bimanual movements) and later progression to "forced use" of the affected arm. The end result was increased functional use of the affected upper limb.
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keywords = visual
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3/30. Illusory movements of the paralyzed limb restore motor cortex activity.

    In humans, limb amputation or brachial plexus avulsion (BPA) often results in phantom pain sensation. Actively observing movements made by a substitute of the injured limb can reduce phantom pain, Proc. R. Soc. london B Biol. Sci. 263, 377-386). The neural basis of phantom limb sensation and its amelioration remains unclear. Here, we studied the effects of visuomotor training on motor cortex (M1) activity in three patients with BPA. Functional magnetic resonance imaging scans were obtained before and after an 8-week training program during which patients learned to match voluntary "movements" of the phantom limb with prerecorded movements of a virtual hand. Before training, phantom limb movements activated the contralateral premotor cortex. After training, two subjects showed increased activity in the contralateral primary motor area. This change was paralleled by a significant reduction in phantom pain. The third subject showed no increase in motor cortex activity and no improvement in phantom pain. We suggest that successful visuomotor training restores a coherent body image in the M1 region and, as a result, directly affects the experience of phantom pain sensation. Artificial visual feedback on the movements of the phantom limb may thus "fool" the brain and reestablish the original hand/arm cortical representation.
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ranking = 0.4477121706904
keywords = visual, cortex
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4/30. Visuomotor performance in a patient with visual agnosia due to an early lesion.

    We tested a patient with visual agnosia who had suffered severe bilateral brain damage early in life, on a series of visuomotor tasks. The broad pattern of results confirms that S.B., like the extensively tested patient D.F., shows an impressive array of preserved skills, despite his severe perceptual problems. Also like D.F., S.B. shows certain subtle visuomotor difficulties that can be related to the idea that his partially intact occipito-parietal areas are unable to benefit from interactions with the apparently severely damaged occipito-temporal regions. Unlike D.F., however, he is able to make accurate discriminations of simple visual features, such as object width and orientation, albeit with very slow response times. We hypothesize that several factors such as the early onset of S.B.'s lesion and the long period since his brain lesion have allowed his brain to compensate to a degree what has been impossible in D.F., whose brain damage occurred in adulthood. This may include an element of 'rewiring' and self-monitoring of visuomotor processes that allow S.B. to achieve perceptual access to visual information processed in the dorsal stream: information that is normally only available for on-line visuomotor control.
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keywords = visual
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5/30. Charles Bonnet syndrome and visual acuity--the involvement of dynamic or acute sensory deprivation.

    A 61-year-old patient suffered from Charles Bonnet syndrome (CBS) while his visual acuity declined, whereas CBS subsided after he became blind. These findings suggest that reduction of visual acuity (dynamic or acute impairment) has a greater impact on the onset of CBS than low visual acuity (static or chronic impairment) per se in some patients. They may also explain why patients with low visual acuity do not always suffer from CBS. Although further studies are required, the present case highlights the importance of the differentiation between lowering and low visual acuity in the etiology of CBS.
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keywords = visual
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6/30. Illusory persistence of touch after right parietal damage: neural correlates of tactile awareness.

    We studied a patient who experienced 'palinaesthesia', an illusion of persistent touch following tactile stimulation on the left hand, subsequent to a right parietal meningioma affecting primary somatosensory regions in the postcentral gyrus (SI) and superior parietal gyrus (Brodmann area 7), but preserving the secondary somatosensory cortex (SII) in the upper lateral sulcus. This subjective sensation was accompanied by transient increases in objective measures of tactile threshold. The patient had mild deficits in superficial tactile perception, but showed severe left-sided extinction for offsets of tactile stimuli during bilateral stimulation, but not for onsets of stimuli. Functional MRI revealed increased neural activity during palinaesthesia selectively arising within the ipsilesional-right SI cortex, but no abnormality within left SI and bilateral SII. Right SI responded to the onset of new tactile stimuli on the left hand but not to their offset. By contrast, any tactile events on either hand modulated activity in contralateral SII regions, even undetected left-sided offsets. These data demonstrate that illusory persistence of touch following stimulation on the hand may result from sustained neural activity in a restricted region of the SI cortex outlasting the offset of the actual tactile stimuli. These findings also provide direct evidence for a critical role of SI in mediating conscious somatosensory experience on contralateral parts of the body.
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ranking = 0.12044807315303
keywords = cortex
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7/30. hyperglycemia with occipital seizures: images and visual evoked potentials.

    PURPOSE: hyperglycemia may rarely be seen with visual seizures. observation of both visual evoked potentials (VEPs) and magnetic resonance imaging (MRI) in visual status epilepticus (SE) has not been reported. We describe acute and follow-up VEP and MRI findings of a patient with hyperglycemia-related visual SE of occipital origin. methods: In a 59-year-old diabetic woman, complex visual hallucinations and illusions developed with < or =10 seizures per hour as an initial manifestation of nonketotic hyperglycemia. RESULTS: neurologic examination revealed ictal nystagmus to the right and continuous right hemianopsia. Ictal electroencephalography (EEG) and Tc-99m hexamethylpropylene amine oxime (HMPAO) single-photon emission computed tomography (SPECT) revealed an epileptogenic focus in the left occipital lobe. MRI with fluid-attenuated inversion recovery showed focal subcortical hypointensity and gyral hyperintensity. Follow-up MRI showed only minimal gyral hyperintensity at 6 months. The P100 amplitude of VEP was significantly higher at the right occipital area during SE, but slightly higher on the left after the patient had been seizure free for 6 months. CONCLUSIONS: Occipital seizures and hemianopsia can be caused by hyperglycemia and may be accompanied by special MRI and VEP findings.
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ranking = 1.5
keywords = visual
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8/30. Sympathomimetic-induced kaleidoscopic visual illusion associated with a reversible splenium lesion.

    BACKGROUND: Sympathomimetic-induced metabolic derangements within the central nervous system can result in conspicuous changes in neurological functioning and corresponding radiographic abnormalities that can be reversible. OBJECTIVE: To describe a patient with a "kaleidoscopic" visual illusion who was found by magnetic resonance imaging to have a transient lesion in the splenium of the corpus callosum. DESIGN: Case report. SETTING: The University of texas Southwestern Medical Center, Dallas. PATIENT: A 17-year-old adolescent girl who developed an episode of kaleidoscopic vision while using sympathomimetic-containing diet pills that was associated with a reversible lesion of the splenium of the corpus callosum. Her brother has a history of migraine and experienced a similar episode while using illicit stimulant agents. INTERVENTION: Withdrawal of the medication resulted in the cessation of the episodes and normalization of the magnetic resonance image. MAIN OUTCOME MEASURES: Clinical and radiographic improvement. RESULTS: Sympathomimetic-induced metabolic derangements can be associated with reversible lesions within the brain. CONCLUSIONS: We hypothesize that the visual fragmentation was a manifestation of a migraine triggered by sympathomimetic-containing diet pills, and that the transient lesion in the corpus callosum was a manifestation of a reversible metabolic derangement. Both the visual fragmentation and the lesion in the corpus callosum resolved once the patient stopped receiving diet pills.
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ranking = 1.1666666666667
keywords = visual
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9/30. Illusory conjunctions in simultanagnosia: coarse coding of visual feature location?

    Simultanagnosia is a disorder characterized by an inability to see more than one object at a time. We report a simultanagnosic patient (ED) with bilateral posterior infarctions who produced frequent illusory conjunctions on tasks involving form and surface features (e.g., a red T) and form alone. ED also produced "blend" errors in which features of one familiar perceptual unit appeared to migrate to another familiar perceptual unit (e.g., "RO" read as "PQ"). ED often misread scrambled letter strings as a familiar word (e.g., "hmoe" read as "home"). Finally, ED's success in reporting two letters in an array was inversely related to the distance between the letters. These findings are consistent with the hypothesis that ED's illusory reflect coarse coding of visual feature location that is ameliorated in part by top-down information from object and word recognition systems; the findings are also consistent, however, with Treisman's Feature Integration Theory. Finally, the data provide additional support for the claim that the dorsal parieto-occipital cortex is implicated in the binding of visual feature information.
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ranking = 1.0401493577177
keywords = visual, cortex
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10/30. Neuropsychological studies of auditory-visual fusion illusions. Four case studies and their implications.

    A heard speech sound which is not the same as the synchronized speech sound can sometimes give rise to an illusory phonological percept. Typically, a heard /ba/ combines with a seen /ga/ to give the impression that /da/ has been heard (McGurk, H. and MacDonald, J. nature Lond. 264, 746-748, 1976). We report the susceptibility to this illusion of four individuals with localized brain lesions affecting perceptual function. We compare their performance to that of ten control subjects and relate these findings to the efficiency of processing seen and heard speech in separate and combined modalities. The pattern of performance strongly suggests LH specialization for the phonological integration of seen and heard speech. The putative site of such integration can be effectively isolated from unilateral and from bilateral inputs and may be driven by either modality.
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keywords = visual
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