Hallucinations in Neurological Disorders

Clinical Presentation

• Visual hallucinations occur in up to 80% of patients with Parkinson's disease and Dementia with Lewy Bodies, ranging from simple to complex experiences 1
• Peduncular hallucinations are distinguished from Charles Bonnet Syndrome, which is characterized by visual hallucinations with preserved insight and vision loss 2
• Charles Bonnet Syndrome is characterized by visual hallucinations occurring in patients with vision loss and preserved insight, without other neurological explanations 1

Assessment and Evaluation

• The Neuropsychiatric Inventory (NPI) is a structured caregiver interview designed to detect and quantify neuropsychiatric symptom changes in people with dementia 3
• The North-East Visual Hallucination Interview (NEVHI) specifically assesses visual hallucinations with both patient and informant versions, showing strong correlation with MDS-UPDRS hallucination scores 4, 1
• The University of Miami Parkinson's disease Hallucinations Questionnaire captures both severity and frequency of visual hallucinations 4, 1
• The Scale for the Assessment of Positive Symptoms for Parkinson's Disease Psychosis (SAPS-PD) evaluates multiple modalities of hallucinations and other psychotic elements 5