Parkinson’s disease (PD): hallucinations

Evidence-based neurology checklist on parkinson’s disease (pd): hallucinations: 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…

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

Clinical features of visual hallucinations

Predictors

Differential diagnosis

Auditory hallucination

Other hallucination types

Associations of hallucinations

Treatment: correct triggers

Treatment: withdraw drugs in order of least usefulness

Treatment: antipsychotic drugs

Other treatment: serotonergic drugs

References

  1. Weil R, Reeves S. Hallucinations in Parkinson’s disease: new insights into mechanisms and treatments. ACNR 2020; 19:20-23.
  2. Barnes J, David AS. Visual hallucinations in Parkinson's disease: a review and phenomenological survey. JNNP 2001; 70:727-733.
  3. 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. 
  4. 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.
  5. Holroyd S, Currie L, Wooten GF. Prospective study of hallucinations and delusions in Parkinson's disease. JNNP 2001; 70:734-738.
  6. And 5 more. Subscribe to see the full list

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