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Visual complaints and visual hallucinations in Parkinson's disease

Lookup NU author(s): Dr Alison Killen, Daniel Collerton, Professor Alan ThomasORCiD, Professor David BurnORCiD, Professor Ian McKeith, Dr Urs Mosimann

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Abstract

Background: Visual symptoms are common in Parkinson's disease (PD) and are frequently under-diagnosed. The detection of visual symptoms is important for differential diagnosis and patient management.Aim: To establish the prevalence of recurrent visual complaints (RVC) and recurrent visual hallucinations (RVH) and to investigate their interaction in PD patients and controls.Methods: This cross-sectional study included 88 PD patients and 90 controls. RVC and RVH were assessed with a visual symptom questionnaire and the North-East-Visual-Hallucinations-Interview (NEVHI).Results: Double vision (PD vs. Controls: 18.2% vs. 1.3%; p < 0.001), misjudging objects when walking (PD vs. Controls: 12.5% vs. 13%; p < 0.01), words moving whilst reading (PD vs. Controls: 17.0% vs. 1.3%; p < 0.001) and freezing in narrow spaces (PD vs. Controls: 30.7% vs. 0%; p < 0.001) were almost exclusively found in PD patients. The same was true for recurrent complex visual hallucinations and illusions (PD vs. Controls: both 17.0% vs. 0%; p < 0.001). Multiple RVC (43.2% vs. 15.8%) and multiple RVH (29.5% vs. 5.6%) were also more common in PD patients (both p < 0.001). RVC did not predict recurrent complex visual hallucinations; but double vision (p = 0.018, R-2 = 0.302) and misjudging objects (p = 0.002, R-2 = 0.302) predicted passage hallucinations. Misjudging objects also predicted the feeling of presence (p = 0.010, R-2 = 0.321).Conclusions: Multiple and recurrent visual symptoms are common in PD. RVC emerged as risk factors predictive of the minor forms of hallucinations, but not recurrent complex visual hallucinations. (C) 2013 Elsevier Ltd. All rights reserved.

Publication metadata

Author(s): Urwyler P, Nef T, Killen A, Collerton D, Thomas A, Burn D, McKeith I, Mosimann UP

Publication type: Article

Publication status: Published

Journal: Parkinsonism & Related Disorders

Year: 2014

Volume: 20

Issue: 3

Pages: 318-322

Print publication date: 27/12/2013

ISSN (print): 1353-8020

ISSN (electronic): 1873-5126

Publisher: Elsevier Science

URL: http://dx.doi.org/10.1016/j.parkreldis.2013.12.009

DOI: 10.1016/j.parkreldis.2013.12.009

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