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A Detailed Phenomenological Comparison of Complex Visual Hallucinations in Dementia With Lewy Bodies and Alzheimer's Disease

Published online by Cambridge University Press:  10 January 2005

Clive Ballard
Affiliation:
MRC Neurochemical Pathology Unit, Newcastle General Hospital, Newcastle Upon Tyne, Newcastle, England
Ian McKeith
Affiliation:
University of Newcastle Upon Tyne, Newcastle, England
Richard Harrison
Affiliation:
Bensham Hospital, Tyne & Wear, England
John O'Brien
Affiliation:
University of Newcastle Upon Tyne, Newcastle, England
Peter Thompson
Affiliation:
Bensham Hospital, Tyne & Wear, England
Kath Lowery
Affiliation:
Newcastle General Hospital, Newcastle Upon Tyne, England.
Robert Perry
Affiliation:
University of Newcastle Upon Tyne, Newcastle, England
Paul Ince
Affiliation:
MRC Neurochemical Pathology Unit, Newcastle General Hospital, Newcastle Upon Tyne, Newcastle, England

Abstract

Visual hallucinations (VH) are a core feature of dementia with Lewy bodies (DLB), but little is known about their phenomenology. A total of 73 dementia patients (42 DLB, 30 Alzheimer's disease [AD], 1 undiagnosed) in contact with clinical services were assessed with a detailed standardized inventory. DLB was diagnosed according to the criteria of McKeith and colleagues, AD was diagnosed using the NINCDS-ADRDA criteria. Autopsy confirmation has been obtained when possible. VH were defined using the definition of Burns and colleagues. Detailed descriptions of hallucinatory experiences were recorded. Annual follow-up interviews were undertaken. The clinical diagnosis has been confirmed in 18 of the 19 cases that have come to autopsy. A total of 93% of DLB patients and 27% of AD patients experienced VH. DLB patients were significantly more likely to experience multiple VH that persisted over follow-up. They were significantly more likely to hear their VH speak but there were no significant differences in the other phenomenological characteristics including whether the hallucinations moved, the time of day that they were experienced, their size, the degree of insight, and whether they were complete. VH may be more likely to be multiple, to speak, and to be persistent in DLB patients. These characteristics could potentially aid accurate diagnosis.

Type
Aspects of Dementia
Copyright
© 1997 International Psychogeriatric Association

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