A case of peduncular hallucinosis presenting as a primary psychiatric disorder

Dogan, Vasfiye Burcu; Dırıcan, Ayten Ceyhan; Koksal, Ayhan; Baybaş, Sevim

doi:10.4103/0972-2327.120469

Cited by 7 publications

(3 citation statements)

References 8 publications

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“…The most extensive review to date was published by Chesterman and Boast in 1994 and the most recent review prior to that is a chapter in Specht's 1914 German textbook Wahrnehmung und Halluzination (Specht, 1914). During the 80-year intervening period, as well as during the 20 years since the publication of Chesterman and Boast, MMHs have mainly been referenced in case reports (Alroe and McIntyre, 1983;Scher and Neppe, 1989;Benatar et al, 2000;Lim, 2003;Szűcs et al, 2003;Yee et al, 2005;Mollet et al, 2007;Güzelcan et al, 2008;Vita et al, 2008;Bhat et al, 2012;Dogan et al, 2013), in the field of neuropsychiatry (Aarsland et al, 2001), and in studies in the field of transcultural psychiatry (Zarroug, 1975;Al-Issa, 1977;Ndetei and Singh, 1983;Kent and Wahass, 1996;Blom et al, 2010;Johns et al, 2002;Bauer et al, 2011;Hussein et al, 2012;Larøi et al, 2014;Lim et al, 2015;Luhrmann et al, 2015), see Table 1. Even classic authors such as Parish (1894), Bleuler (1911) and Jaspers (1965), who wrote extensively on hallucinations in various sensory modalities, treated the subject only cursorily.…”

Section: Introductionmentioning

confidence: 97%

Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders

Lim

Hoek

Deen

et al. 2016

Schizophrenia Research

121

102

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We conclude that MMHs, rather than auditory hallucinations, are the most frequent perceptual symptom of patients diagnosed with a schizophrenia spectrum disorder. Our data also suggest that hallucinations experienced in a single sensory modality (notably auditory ones) stochastically increase the risk for more sensory modalities to join in. We recommend that future studies take into account all 14 sensory modalities in which hallucinations can be experienced. For this we provide a classification of MMHs that allows characterization of their serial versus simultaneous occurrence and their congruent versus incongruent nature.

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Section: Introductionmentioning

confidence: 97%

Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders

Lim

Hoek

Deen

et al. 2016

Schizophrenia Research

121

102

View full text Add to dashboard Cite

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“…Finally, alternative explanations may be proposed for the patients showing a lesion also involving the midbrain: this kind of damage has been previously reported to be associated with the development of peduncular hallucinosis and psychosis, whose pathogenesis is still debated ( 31 , 32 ). All these observations suggest that the presence of hallucinations and delusions in some LIS patients can be accounted for by the combination of a damage of the corticopontocerebellar pathways with cortical changes following the primary brainstem injury.…”

Section: Discussionmentioning

confidence: 99%

Cortical Brain Changes in Patients With Locked-In Syndrome Experiencing Hallucinations and Delusions

Sarà¹,

Cornia

Conson

et al. 2018

Front. Neurol.

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Previous evidence suggests that hallucinations and delusions may be detected in patients with the most severe forms of motor disability including locked-in syndrome (LIS). However, such phenomena are rarely described in LIS and their presence may be underestimated as a result of the severe communication impairment experienced by the patients. In this study, we retrospectively reviewed the clinical history and the neuroimaging data of a cohort of patients with LIS in order to recognize the presence of hallucinations and delusions and to correlate it with the pontine damage and the presence of any cortical volumetric changes. Ten patients with LIS were included (5 men and 5 women, mean age 50.1 ± 14.6). According to the presence of indicators of symptoms, these patients were categorized as hallucinators (n = 5) or non-hallucinators (n = 5). MRI images of patients were analyzed using Freesurfer 6.0 software to evaluate volume differences between the two groups. Hallucinators showed a selective cortical volume loss involving the fusiform (p = 0.001) and the parahippocampal (p = 0.0008) gyrus and the orbital part of the inferior frontal gyrus (p = 0.001) in the right hemisphere together with the lingual (p = 0.01) and the fusiform gyrus (p = 0.01) in the left hemisphere. Moreover, a volumetric decrease of bilateral anterior portions of the precuneus was recognized in the hallucinators (right p = 0.01; left p = 0.001) as compared to non-hallucinators. We suggested that the presence of hallucinations and delusions in some LIS patients could be accounted for by the combination of a damage of the corticopontocerebellar pathways with cortical changes following the primary brainstem injury. The above areas are embedded within cortico-cortical and cortico-subcortical loops involved in self-monitoring and have been related to the presence of hallucinations in other diseases. The two main limitations of our study are the small sample of included patients and the lack of a control group of healthy individuals. Further studies would be of help to expand this field of research in order to integrate existing theories about the mechanisms underlying the generation of hallucinations and delusions in neurological patients.

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“…PH has been associated with a range of differing CNS pathologies; 2 , 3 , 5 , 11 , 12 however, regardless of the etiology, lesions of midbrain and/or pontine structures appear to be crucial for the characteristic cognitive defects. The mechanism for PH implicates the brainstem reticular formation, its thala-mic targets and the projections connecting the two.…”

Section: Discussionmentioning

confidence: 99%

Peduncular hallucinosis associated with a pontine cavernoma

et al. 2018

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Peduncluar hallucinosis is a rare neurological disorder characterized by visual hallucinations, often described to be vivid and dream-like. While the exact pathophysiology has yet to be elucidated, most cases to date have suggested an etiology stemming from lesions to the thalamus or midbrain. Here presented is a case of a 54-year-old female with peduncular hallucinosis secondary to a pontine cavernoma hemorrhage in the setting of essential hypertension. The patient’s vivid visual and auditory hallucinations aligned temporally with the lesion’s discovery and resolved after pharmaceutical treatment. This case represents a rare form of peduncular hallucinosis secondary to a pontine cavernoma hemorrhage leading to vasospasm in the arteries feeding the brain-stem.

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A case of peduncular hallucinosis presenting as a primary psychiatric disorder

Abstract: Peduncular hallucinosis usually occurs due to vascular or infectious midbrain lesions or brain stem compression by tumors. We present a peduncular hallucinosis case in a 63-year-old female with brain stem infarction, which can easily be misdiagnosed as a psychiatric disorder.

Cited by 7 publications

References 8 publications

Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders

Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders

Cortical Brain Changes in Patients With Locked-In Syndrome Experiencing Hallucinations and Delusions

Peduncular hallucinosis associated with a pontine cavernoma

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