A previously healthy elderly patient with a recent onset of macular degeneration presented for evaluation of elaborate complex visual hallucinations. The patient's psychiatric evaluation and level of cognitive functioning were normal. A diagnosis of organic hallucinosis secondary to macular degeneration was made, and the hallucinations ceased with increased sensory stimulation in the hospital. Numerous diagnoses were considered and are discussed, including Charles Bonnet hallucinations and peduncular hallucinosis.
References
1.
Diagnostic and statistical manual of mental disorders, third edition, revised. Washington DC: American Psychiatric Press, Inc., 1987.
2.
HolroydS., RabinsP.V., FinkelsteinD.Visual hallucinations in patients with macular degeneration.Am J Psychiatry1992; 149(12): 1701–1706.
3.
TuckerG.J., CaineE.D., FolsteinM.F.Introduction to background papers for the suggested changes to DSM-IV: cognitive disorders.J Neuropsychiatry Clin Neurosci1992; 4(4): 360–368.
4.
LhermitteM.J.Syndrome de la calotte du pédoncule cérébral. Les troubles psycho-sensoriels dans les lésions du mésocéphale.Revue Neurologique1922; 38: 1359–1365.
5.
CaplanL.R.“Top of the Basilar” syndrome.Neurology1980; 30: 72–79.
6.
van BogaertL.Syndrome inférieur du noyau rouge, troubles psychosensoriels d'origine mésocéphalique.Revue Neurologique1924; 40: 41–64.
7.
van BogaertL.L'hallucinose pédonculaire.Revue Neurologique1927; 43: 608–617.
8.
RozanskiJ.Peduncular hallucinosis following vertebral angiography.Neurology1952; 2: 341–349.
9.
ColeM.G.Charles Bonnet hallucinations: a case series.Can J Psychiatry1992; 37(4): 267–270.
10.
SchultzG., MelzackR.The Charles Bonnet syndrome: “phantom visual images.”Perception1991; 20: 809–825.
11.
FolsteinM.F., FolsteinS.E., McHughP.R.“Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res1975; 12: 189–198.
12.
BenderM.B., RudolphS.H., StacyC.B.The neurology of the visual and oculomotor systems, 1982. In: JoyntR.J. ed. Clinical neurology: 1(12).Philadelphia PA: J.B. Lippincott Company, 1977.
