Visual hallucinations on eye closure after orthopedic surgery under general anesthesia

Otomo, Sumi; Sugita, Michiko; Yano, Toshiyuki

doi:10.1007/s00540-008-0665-8

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…Closed-eye visual hallucinations have previously been reported following general anesthesia, local anesthesia with lidocaine, and atropine poisoning. [15][16][17][18][19] While hallucinations are not strictly a sensory misperception, these closed-eye visual hallucinations may be considered an AIWS symptom in view of its link to the patient's VM attacks, and because hallucinations (e.g., zoopsia) have been considered manifestations of AIWS in previous publications. 3,8 An unusual finding in our cohort is the high proportion (41%) with extrapersonal misperceptions (4 with out-ofbody experiences, 2 with derealization, 1 with depersonalization) compared to other migraine-related AIWS studies.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of Alice in Wonderland syndrome in a cohort with vestibular migraine

Beh

Masrour²,

Smith³

et al. 2018

Neur Clin Pract

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BackgroundAlice in Wonderland syndrome (AIWS) is a rare sensory perception disorder, most often caused by migraine in adults. We aimed to characterize the clinical characteristics of AIWS in a cohort of vestibular migraine (VM) patients.MethodsRetrospective chart review of patients diagnosed with VM seen between August 2014 and January 2018.ResultsSeventeen patients were identified (10 women) with a median age at onset of 45 years (range 15–61 years), and median age at presentation of 49 years (range 17–63 years). Eighty-two percent reported 1 AIWS symptom, 12% reported 3 symptoms, and 6% described 2 symptoms. The most common symptom was visual distortions (47%), followed by extrapersonal misperceptions (41%) and somesthetic distortions (29%). Most AIWS occurred during VM episodes (77%). Eleven patients were seen in follow-up; 10 described complete or partial resolution of both AIWS and VM with migraine preventive therapy, while 1 experienced complete resolution of VM but continued to have AIWS. Neuro-otologic abnormalities improved in 2 patients.ConclusionsThis study characterizes the clinical features of AIWS in patients with VM. We observed several rare and highly unusual AIWS misperceptions (frosted-glass vision, underwater vision, dolly zoom effect, sensation of the brain coming out of the head, closed-eye visual hallucinations, and headlight glare–induced marco/microsomatognosia), and resolution or improvement in AIWS and VM with migraine preventive treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of Alice in Wonderland syndrome in a cohort with vestibular migraine

Beh

Masrour²,

Smith³

et al. 2018

Neur Clin Pract

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“…A unifying feature of these hallucinations is that they occur when the patient's eyes are open. A review of the literature shows that cases of closed-eye hallucinations have been reported in postoperative patients who received general anesthesia or rarely in temporal lobe epilepsy [ 3 ]. The patient in this case had not received any drugs known to be hallucinogenic and did not have history of seizures or any evidence of seizure during hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Closed-Eye Visualizations in the Setting of Hyponatremia

Peck

Mercogliano

York

2018

Case Reports in Medicine

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Purpose To report a case of closed-eye visualizations and to clarify the different types of hallucinations and their etiologies. Methods Retrospective case report of a patient with closed-eye visualizations secondary to hyponatremia. Clinical findings, physical exam, laboratory assessment, treatment, and disease course from the patient's hospitalization were used in creating this report. Follow-up data after discharge were also obtained. Results Closed-eye visualizations were diagnosed as secondary to hyponatremia, as they did not occur with the eyes open, and potential alternate causes were excluded. Serum sodium nadir was 119 mEq/L. Symptoms resolved with correction of hyponatremia via fluid resuscitation and electrolyte replenishment. There has been no recurrence of the symptoms. Conclusion This patient had hallucinations exclusively with the eyes closed, which must be differentiated from the release hallucinations seen with the eyes open in Charles Bonnet syndrome. This patient had no visual loss or retinal disease, which should be suspected in open eye hallucinations.

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“…Previous cases of visual hallucinations occurring on eye closure have been reported following hip surgery under general anaesthesia [1], local anaesthesia with lidocaine [2,3], atropine administration [4], cardiovascular surgery [5,6], traumatic subdural hematoma in the left occipital region [7], trans-sphenoidal adenomectomy [8] and posterior callosal stroke [9]. The triggering of hallucinations by eye closure can be linked to the "cortical release phenomenon" due to visual Visual Hallucinations with Disembodiment and Self-Motion Illusion on Eye Closure after Brain Cyst Drainage: A Case Report deafferentation in Charles-Bonnet Syndrome [7].…”

Section: Discussionmentioning

confidence: 99%

“…We report the first documented case of visual hallucinations associated with disembodiment and self-motion illusion, observed after brain cyst drainage. Visual hallucinations on eye closure have been previously reported [1][2][3][4][5][6][7][8][9], but never with disembodiment nor self-motion illusion.…”

Section: Case Reportmentioning

confidence: 99%

Visual Hallucinations with Disembodiment and Self-Motion Illusion on Eye Closure after Brain Cyst Drainage: A Case Report

Sontheimer¹,

Coll²,

Mathais³

et al. 2019

Neuropsychiatry

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BackgroundWe report the first documented case of visual hallucinations with disembodiment and selfmotion illusion on eye closure. Clinical presentationA 71-year-old woman was operated on for a cyst of the left centrum semiovale, adjacent to the precuneus, the posterior cingulate cortex and the splenium of corpus callosum. Two days after, she complained of visual hallucinations occurring on eye closure. She reported reminiscences of landscapes, trees and animals. She had a sensation of floating and moving, flying over the landscapes or walking on lanes. She could stop the hallucinations by opening her eyes. The hallucinations lasted for six days. Pharmacological and neurological possible origins of the hallucinations were explored. ConclusionNo direct relation could be found between the pharmacological treatment and the hallucinations. Cerebral volumetric analysis showed a structural reorganization following cyst drainage, which might have conducted to transient hyper excitability of the surrounding structures. The release phenomenon induced by eye closure might have triggered the activation of a distributed network within associative visual, parietal and temporal cortices. The involvement of the splenium and the cingulum is discussed. Furthermore, MRI-and DTI-follow-up suggests that structural reorganization after surgery can be spread over long periods until disappearance of cyst-related deformations. Stabilization of cyst volume, near to zero, was observed after about 2 years.

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Visual hallucinations on eye closure after orthopedic surgery under general anesthesia

Cited by 9 publications

References 12 publications

Clinical characteristics of Alice in Wonderland syndrome in a cohort with vestibular migraine

Clinical characteristics of Alice in Wonderland syndrome in a cohort with vestibular migraine

Closed-Eye Visualizations in the Setting of Hyponatremia

Visual Hallucinations with Disembodiment and Self-Motion Illusion on Eye Closure after Brain Cyst Drainage: A Case Report

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