Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
Department of Neurology, University of Cincinnati.
Neurocase. 2021 Apr;27(2):205-208. doi: 10.1080/13554794.2021.1915338. Epub 2021 Apr 18.
An 81-year-old female presented with a right pontine infarct and later developed recurrent vivid hallucinations. After a workup for delirium and hallucinosis was unrevealing, a diagnosis of peduncular hallucinosis (PH) was proposed. Treatment with quetiapine and, later, adjunctive nightly melatonin resulted in return to cognitive baseline. An array of etiologies can be responsible for visual hallucinations, including PH. Herein, we review several disorders of hallucinosis and their diagnostic workup. Additionally, we explore the pathophysiology of PH and its association with the pontine-geniculate-occipital (PGO) pathway and propose why correction of the sleep-wake cycle may benefit patients with PH.
一位 81 岁女性因右侧脑桥梗死就诊，随后出现反复发作的生动幻觉。在对谵妄和幻觉进行了一系列检查但未发现异常后，提出了动眼神经核性幻觉（PH）的诊断。使用喹硫平和随后的夜间辅助性褪黑素治疗后，认知功能恢复基线水平。一系列病因都可能导致视觉幻觉，包括 PH。在此，我们回顾了几种幻觉障碍及其诊断方法。此外，我们还探讨了 PH 的病理生理学及其与桥脑-膝状体-枕叶（PGO）通路的关系，并提出了为什么纠正睡眠-觉醒周期可能对 PH 患者有益的原因。
