Parkinson’s disease (PD): hallucinations
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Parkinson’s disease (PD): hallucinations. These are caused by the breakdown of perception and attention networks. Fully referenced neurology checklist.
Pathophysiology
- These are caused by the breakdown of perception and attention networks
- There may be associated reduced connectivity of thalamic projections
- There may also be a failure to integrate sensory information with previous knowledge
- The neurotransmitters involved are dopamine, serotonin, acetylcholine, and GABA
Visual hallucination types
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Clinical features of visual hallucinations
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Predictors
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Differential diagnosis
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Auditory hallucination
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Other hallucination types
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Associations of hallucinations
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Treatment: correct triggers
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Treatment: withdraw drugs in order of least usefulness
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Treatment: antipsychotic drugs
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Other treatment: serotonergic drugs
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References
- Weil R, Reeves S. Hallucinations in Parkinson’s disease: new insights into mechanisms and treatments. ACNR 2020; 19:20-23.
- Barnes J, David AS. Visual hallucinations in Parkinson's disease: a review and phenomenological survey. JNNP 2001; 70:727-733.
- Toh WL, Yolland C, Gurvich C, Barnes J, Rossell SL. Non-visual hallucinations in Parkinson's disease: a systematic review. J Neurol 2023; 270:2857-2889.
- Lenka A, Pagonabarraga J, Pal PK, Bejr-Kasem H, Kulisvesky J. Minor hallucinations in Parkinson disease: A subtle symptom with major clinical implications. Neurology 2019; 93:259-266.
- Holroyd S, Currie L, Wooten GF. Prospective study of hallucinations and delusions in Parkinson's disease. JNNP 2001; 70:734-738.
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