Complex visual hallucinations and delusional infestation comorbidity

Rocha, Fábio Lopes; Caramelli, Paulo; Oliveira, Lívia Costa de

doi:10.1590/s0004-282x2012000700017

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…Among four prior cases of delusional infestation diagnosed with DLB, two patients had visual hallucinations (7)(8)(9). Even in cases of suspected dementia in which a diagnosis of DLB had not been made, the coexistence of complex visual hallucinations and delusional infestation have been reported (15)(16)(17). The patient reported by Kanazawa and Hata was suspected of having Alzheimer's dementia (15), and the case was reported before the publication of the first criteria for DLB (18).…”

Section: Discussionmentioning

confidence: 99%

“…The patient reported by Kanazawa and Hata was suspected of having Alzheimer’s dementia ( 15 ), and the case was reported before the publication of the first criteria for DLB ( 18 ). Although the patient reported by Rocha et al showed cognitive impairment, the diagnosis was unclear because the patient refused detailed examinations and evaluation and was also limited by visual deficits and hypoacusis ( 16 ). Another case reported by Hirakawa et al was suspected of having DLB, and donepezil hydrochloride was prescribed ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

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Case report: Delusional infestation in dementia with Lewy bodies

Taomoto

Kanemoto²,

Satake³

et al. 2022

Front. Psychiatry

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BackgroundDelusional infestation is characterized by delusions of being infested with parasites, vermin, or small insects and is frequently accompanied by tactile and visual hallucinations. Herein, we report two cases of dementia with Lewy bodies (DLB) with delusional infestation.Case presentationCase 1 was an 83-year-old man. At the age of 75, he began to show symptoms of rapid eye movement sleep behavior disorder. At the age of 83, he began to complain of visual hallucinations of people and delusional infestation with tactile and visual hallucinations of insects, resulting in the use of insecticides for non-existent insects. He also complained of mild amnesia and was admitted to our psychiatric ward for evaluation and treatment. After admission, the delusional infestation disappeared without any new medication. Based on our examinations, he was diagnosed with probable DLB with delusional infestation. He was treated with 5 mg/day of donepezil hydrochloride; his visual and tactile hallucinations disappeared, and the delusional infestation had not recurred at the 1-year follow-up. Case 2 was a 69-year-old woman. At the age of 60, she underwent clipping for subarachnoid hemorrhage (SAH). At the age of 65, she began to have visual hallucinations of people. At the age of 67, she began to complain of visual illusions in which she mistook lint for insects. At the age of 69, she developed delusional infestation and mild amnesia. She took various actions to get rid of these non-existent insects, including insecticide use, consulting an exterminator, and visiting several dermatologists. She eventually burnt her leg in an attempt to kill the non-existent insects. Based on our examinations, she was diagnosed with prodromal DLB in addition to SAH sequelae. We determined that her delusional infestation was caused by DLB rather than SAH sequelae based on the course of her symptoms. She was treated with a combination of 3 mg/day of donepezil hydrochloride and 12.5 mg/day of quetiapine. Thereafter, the delusional infestation partially improved, and she took no further action against non-existent insects.ConclusionDelusional infestation may be caused by DLB. Acetylcholinesterase inhibitors (AChEI) may be effective for delusional infestation in DLB, although antipsychotics may also be needed in severe cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case report: Delusional infestation in dementia with Lewy bodies

Taomoto

Kanemoto²,

Satake³

et al. 2022

Front. Psychiatry

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“…Date ranges were not specified for any searches. Complete searches resulted in 42 case studies 3,5–31 utilised in this article, and a review of these cases was completed in April 2015 (see Table 1). Since this time, we have uncovered through repeat searches a further 64 case studies to be reviewed and reported in a later publication.…”

Section: Literature Searchmentioning

confidence: 99%

Delusional infestation: the case for improved mental state testing

O'Connell

Jackson

2016

Australas Psychiatry

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“…5 To our knowledge, there are only two case reports showing complex visual hallucinations and coexistent delusional parasitosis. 6,7 We report a third case and discuss the mechanism of coexistence from the viewpoint of micropsia.…”

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confidence: 91%

Coexistence of Delusional Parasitosis and Complex Visual Hallucinations With Micropsia

Terao

Kanehisa

Ninomiya

et al. 2016

JNP

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To the Editor: Complex visual hallucinations consist of people, deformed faces, animals, and complex scenes, which are often associated with various clinical diseases such as delirium tremens, Parkinson's disease, dementia with Lewy bodies, Charles Bonnet syndrome, and schizophrenia. 1,2 Delusional parasitosis can be defined as a delusional syndrome that primarily affects middle-aged and elderly individuals (mainly women) and consists of the belief that parasites plague the skin. 3 Of historical note, Berrios 3,4 rediscovered the term délire de zoopathie interne initially described by Dupré and Levy as a wider condition of delusion of parasitosis, which included the belief that one's body was inhabited by all types of animals. The 29 cases reported by Dupré and Levy involved rats, birds, snakes, and other animals, but no insects were mentioned. 3,4 It seems likely that animals such as rats and birds appeared smaller than usual in the delusion of parasitosis, suggesting the coexistence of micropsia. Micropsia is one of the metamorphopsias and is defined as a symptom of objects appearing smaller than usual. Micropsia has been attributed to a dysfunction of object constancy within the temporal lobe, but lesions of the lateral occipitotemporal cortex may also cause micropsia, which may relate to a deficit of object processing rather than constancy. 5 To our knowledge, there are only two case reports showing complex visual hallucinations and coexistent delusional parasitosis. 6,7 We report a third case and discuss the mechanism of coexistence from the viewpoint of micropsia.

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Complex visual hallucinations and delusional infestation comorbidity

Cited by 7 publications

References 5 publications

Case report: Delusional infestation in dementia with Lewy bodies

Case report: Delusional infestation in dementia with Lewy bodies

Delusional infestation: the case for improved mental state testing

Coexistence of Delusional Parasitosis and Complex Visual Hallucinations With Micropsia

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