Department of Neurology, Bangur Institute of Neurosciences, Institute of Post-Graduate Medical Education and Research, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Cogn Behav Neurol. 2020 Dec;33(4):266-270. doi: 10.1097/WNN.0000000000000247.
Palinopsia refers to the abnormal persistence, or recurrence, of visual images after a visual stimulus has subsided. We describe here a case of palinopsia accompanied by a visual motion perception disorder as manifested by moving afterimages. A 71-year-old man presented to us after having experienced acute-onset, vivid, visual hallucinations for 1 week. A detailed history revealed that he was hallucinating multiple living and nonliving objects. He also complained of a persistence of afterimages, particularly in the left visual field. He reported that, on a few occasions, while sitting by the window in his room, he had seen a moving car on the road; immediately after the car had disappeared from his sight, he had then seen the same car moving backward at almost the same speed-as if the driver had applied the reverse gear. A neuropsychological assessment did not reveal any deficits in attention, language, or episodic memory. Visual field testing by confrontational perimetry suggested left hemianopia. An MRI of the brain revealed an arteriovenous malformation in the medial part of the right occipital lobe, affecting both the lingual gyrus and the inferior occipital gyrus. Palinopsia has generally been described in reference to static afterimages. In our case, not only was the afterimage that was perceived by the patient in motion, but the direction of the movement was also opposite to that of the actual object. We propose the term dyskinetopsic palinopsia, or simply motion-related palinopsia, for this particular condition.
幻视是指视觉刺激消失后，视觉图像异常持续或重现。我们在此描述一例幻视伴视觉运动感知障碍的病例，表现为运动后像。一名 71 岁男性因突发、生动的视觉幻觉持续 1 周就诊。详细病史显示，他正在幻视多个活体和非活体物体。他还抱怨有后像持续存在，特别是在左视野。他报告说，有几次他坐在房间的窗户旁，看到路上有一辆移动的汽车；汽车从他的视线中消失后，他看到同一辆汽车以几乎相同的速度向后移动——就好像司机已经挂了倒档。神经心理学评估未显示出注意力、语言或情景记忆方面的缺陷。对向性视野检查提示左侧偏盲。大脑 MRI 显示右侧枕叶内侧的动静脉畸形，累及舌回和下枕回。幻视通常是指静态后像。在我们的病例中，不仅患者感知到的后像是运动的，而且运动的方向与实际物体的方向相反。我们提出“运动性视错觉性幻视”或简称“与运动相关的幻视”这一特定术语。
