Visual Hallucinations in Posterior Cortical Atrophy

Abstract

Background: Visual hallucinations have been reported to occur in up to 25% of patients who meet the criteria for posterior cortical atrophy (PCA). It is not known, however, whether patients who meet the criteria for PCA and have hallucinations are different from those who meet the criteria and do not have hallucinations.Objective: To compare the clinical and imaging features of patients with PCA with and without wellformed visual hallucinations.Design: Case-control study.Setting: Tertiary care medical center.Patients: Fifty-nine patients fulfilling the criteria for PCA were retrospectively identified and divided into 2 groups based on the presence (n = 13) or absence (n = 46) of visual hallucinations.Main Outcome Measures: Statistically significant clinical differences and imaging differences using voxelbased morphometry between the 2 groups.

Distinguishing Neuroimaging Features in Patients Presenting with Visual Hallucinations

“…47,48 VHs are seen in approximately 25% of patients diagnosed with the posterior cortical atrophy variant of Alzheimer disease, in which cortical loss is localized, particularly to the occipital and parietal lobes, leading to visual agnosia and apraxia. 49 Those patients with posterior cortical atrophy and complex VHs have disproportionate involvement of the midbrain, thalamus, and primary visual cortex, and interplay between these regions may be responsible. 49 Imaging Features.…”

Posterior kortikal atrofi

“…Noen får vansker med å gjenkjenne eller lokalisere objekter. Andre rapporterer om feilbedømming av avstand og vansker med å gå i trapper som OVERSIKTSARTIKKEL initiale symptomer (12), eller at de bommer på, eller kolliderer med, objekter (13).…”

“…Visuelle hallusinasjoner er blitt rapportert hos en knapp firedel av pasientene (6,12). Disse opptrer vanligvis som spontane, residiverende synsopplevelser og kan forekomme både i tidlig og sent stadium av sykdommen.…”

“…Midthjerne og basalganglier er affisert hos dem som har hallusinasjoner, og dette kan muligens forklare hvorfor disse pasientene (> 75 %) i tillegg har parkinsonistiske symptomer (12).…”

Haliucinacijų etiologijos aspektai

“…Ši liga manifestuoja 50-65 gyvenimo metais. Pažeidžiamos pakaušinė, momeninė, pakaušinė bei smilkininė galvos smegenų sritys, vystosi jų atrofija, paprastai asimetrinė, taip pat stebima šių sričių hipoperfuzija (17). Pirminės regimosios žievės, vidurinių smegenų ir pamato branduolių atrofija labiau išryškėjusi haliucinacijas patiriantiems individams nei nepatiriantiems, kurie serga Benson sindromu.…”