1/256. A puzzling case of seizures and visual hallucinations during clomipramine treatment with a high dose but causing a low serum concentration.We present a puzzling case of a 25-year-old depressive man suffering from seizures and visual hallucinations during clomipramine treatment with a high dose but causing a low serum concentration. We examined alleles of cytochrome P450 (CYP) isozymes. It was revealed that he was not an ultrarapid metabolizer for CYP2D6, and that the genotypes were homozygous for CYP2D6J and heterozygous for CYP2C19m1. Throughout the treatment period, his compliance was good. Since he was a smoker, it seems likely that his low clomipramine level was due to smoking-induced CYP1A2 activity. These findings suggest that smoking-induced CYP1A2 activity overcomes the possibly inhibiting effects of homozygosity for CYP2D6J and heterozygosity for CYP2C19m1, and that high-dose clomipramine is not always a direct cause of seizures.- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
2/256. Dialogical engagement with voices: a single case study.This paper raises the possibility that a dialogical, or discursive, model of human experience may be useful in helping someone who experiences verbal hallucinations. The model regards verbal hallucinations as a variety of inner speech with dialogical properties. The explication of these properties in the context of a personal narrative allowed the individual to engage in dialogue with the voices, through the medium of a new, supportive and positive voice. This process made it possible to introduce moral responses to distressing and potentially dangerous imperative verbal hallucinations, through the mediation of the new voice. Her dialogical engagement with this voice enabled her to deal effectively with troublesome voices, and was a powerful source of self-esteem. We briefly present the theoretical perspective underlying this approach, and compare and contrast the approach with cognitive-behavioural techniques.- - - - - - - - - - ranking = 0.00033016891520943keywords = contrast (Clic here for more details about this article) |
3/256. When the left brain is not right the right brain may be left: report of personal experience of occipital hemianopia.OBJECTIVES: To make a personal report of a hemianopia due to an occipital infarct, sustained by a professor of neurology. methods: Verbatim observation of neurological phenomena recorded during the acute illness. RESULTS: Hemianopia, visual hallucinations, and non-occipital deficits without extraoccipital lesions on MRI, are described and discussed. CONCLUSIONS: Hemianopia, due to an occipital infarct, without alexia, is not a disability which precludes a normal professional career. Neurorehabilitation has not been necessary.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
4/256. cisapride in the treatment of visual hallucinations caused by vision loss: the Charles Bonnet syndrome.The authors describe the use of cisapride (Propulsid), a potent 5-HT(3) antagonist, in the treatment of visual hallucinations in two patients with vision loss (the Charles Bonnet syndrome).- - - - - - - - - - ranking = 1keywords = visual (Clic here for more details about this article) |
5/256. Peduncular hallucinosis: an unusual sequel to surgical intervention in the suprasellar region.Peduncular hallucinations are formed visual images often associated with sleep disturbance, and are caused by lesions in the midbrain, pons and diencephalon. In the present study, we report two patients who developed peduncular hallucinations following surgery in the suprasellar region. In one of these, the peduncular hallucinations were a sequel to endoscopic third ventriculostomy, while in the other, they were due to diencephalon and mid-brain compression by a postoperative clot following excision of a hypothalamic astrocytoma.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
6/256. cluster headache with aura.cluster headache with aura is rare. The authors retrospectively reviewed 101 cluster headache patient charts at the Jefferson Headache Center. Six patients had an associated aura, five visual and one olfactory, lasting 5 to 120 minutes. Only one had migraine (without aura). Auras always occurred with or were followed by a severe cluster headache. Two patients were related.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
7/256. Palinopsia and polyopia in the absence of drugs or cerebral disease.OBJECTIVE: To report the occurrence of palinopsia and polyopia in patients who neither used drugs nor had diseases of the cerebral hemispheres, a group in which these visual symptoms have not been reported. METHOD: The patient records in the database of an academic neuro-ophthalmology unit were reviewed. RESULTS: Seventeen patients were identified in the database with the diagnosis of palinopsia or polyopia, of whom eight had diseases of the cerebral hemispheres, leaving nine patients for analysis. No patients with a history of drug toxicity were identified. In one patient the symptoms presented during an initial episode of demyelinative optic neuritis in the absence of clinical or laboratory evidence of cerebral lesions. In another patient they developed immediately after laser treatment of diabetic macular edema. A third patient developed the symptoms in association with visual loss from Leber's hereditary optic neuropathy. The other six patients were healthy individuals. CONCLUSION: Palinopsia and related visual symptoms can occur in otherwise healthy individuals and in patients with disease apparently confined to the eye or the optic nerve.- - - - - - - - - - ranking = 0.6keywords = visual (Clic here for more details about this article) |
8/256. Atypical Charles Bonnet hallucinations: an elf in the woodshed, a spirit of evil, and the cowboy malefactors.In this article, the authors review the literature on the Charles Bonnet syndrome (CBS), a condition involving visual hallucinations in normal persons with severe sight loss. Attempts to assess the characteristics of this "phantom vision" have resulted in descriptions of a "typical" CBS hallucination. However, the many exceptions to a modal CBS experience cause the authors to postulate two other general categories of CBS hallucinations: a) the atypical sensory/perceptual (ASP), and b) the atypical psychodynamic (APD) hallucinations. Case studies illustrating these two types are provided. Extending the categories of Charles Bonnet hallucinations allows for more specific diagnosis, treatment, and may result in the possibility of greater precision in future research.- - - - - - - - - - ranking = 0.2keywords = visual (Clic here for more details about this article) |
9/256. Estrogen and visual hallucinations in a patient with Charles Bonnet syndrome.PURPOSE: To describe the occurrence of visual hallucinations in a patient with Charles Bonnet syndrome associated with estrogen intake. METHOD: Case report. RESULTS: An 84-year-old woman with poor visual acuity secondary to bilateral, nonexudative, age-related macular degeneration had nonthreatening visual hallucinations 2 weeks after starting oral estrogen for osteoporosis. The estrogen was stopped, and the hallucinations subsided. The patient was given estrogen twice more and each time the hallucinations recurred. CONCLUSION: We report a case of Charles Bonnet syndrome associated with estrogen intake in an 84-year-old woman. Estrogen may have promoted release phenomena and triggered the hallucinatory episodes in our patient.- - - - - - - - - - ranking = 1.4keywords = visual (Clic here for more details about this article) |
10/256. hallucinations in Parkinson's disease: prevalence, phenomenology and risk factors.hallucinations, mainly of a visual nature, are considered to affect about one-quarter of patients with Parkinson's disease. They are commonly viewed as a side-effect of antiparkinsonian treatment, but other factors may be involved. The aim of this study was to determine the phenomenology, prevalence and risk factors of hallucinations in Parkinson's disease. Two-hundred and sixteen consecutive patients fulfilling clinical criteria for Parkinson's disease were studied. Demographic and clinical variables were recorded, including motor and cognitive status, depressive symptoms and sleep-wake disturbances. patients with and without hallucinations were compared using non-parametric tests, and logistic regression was applied to significant data. hallucinations had been present during the previous 3 months in 39.8% of the patients, and fell into three categories: minor forms, consisting of a sensation of a presence (person), a sideways passage (commonly of an animal) or illusions were present in 25.5% of the patients (an isolated occurrence in 14.3%), formed visual hallucinations were present in 22.2% (isolated in 9.3%) and auditory hallucinations were present in 9.7% (isolated in 2.3%). patients with minor hallucinations had a higher depression score than non-hallucinators but did not differ in other respects. Logistic regression analysis identified three factors independently predictive of formed visual hallucinations: severe cognitive disorders, daytime somnolence and a long duration of Parkinson's disease. These findings indicate that, when minor hallucinations are included, the total prevalence is much higher than previously reported. A simple side-effect of dopaminergic treatment is not sufficient to explain the occurrence of all visual hallucinations. The main risk factor in treated patients is cognitive impairment, although sleep-wake cycle disturbances, and possibly other factors related to the duration of the disease, act as cofactors.- - - - - - - - - - ranking = 0.8keywords = visual (Clic here for more details about this article) |
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