Paulson G W
Ohio State University Hospital, Columbus 43210, USA.
Gerontology. 1997;43(5):255-60. doi: 10.1159/000213859.
Visual hallucinations, without auditory hallucinations and in the elderly, are not usually based on previous psychiatric illness. The elderly can, of course, hallucinate as part of severe depression or a life-long schizophrenia, but the clinician should assume that there is an organic basis when an elderly individual begins to develop visual hallucinations for the first time. Representative cases that illustrate visual hallucinations due to ophthalmological, vascular, or degenerative processes are presented. Visual hallucinations can be linked to disorders in multiple parts of the nervous system. Even when related to medications, dementia may also be contributory, as is illustrated by the hallucinations seen in those with Parkinson's disease. Treatment of visual hallucinations is treatment of the underlying cause although some newer drugs such as clozapine may also be helpful for selected patients.
在老年人中，仅有视幻觉而无听幻觉，通常并非基于既往精神疾病。当然，老年人可能会在重度抑郁或终生精神分裂症的情况下出现幻觉，但当老年人首次开始出现视幻觉时，临床医生应假定存在器质性基础。本文介绍了一些因眼科、血管或退行性病变过程导致视幻觉的典型病例。视幻觉可能与神经系统多个部位的疾病有关。即使与药物有关，痴呆也可能起作用，帕金森病患者出现的幻觉就是例证。视幻觉的治疗是针对潜在病因进行治疗，不过一些新药，如氯氮平，对部分患者可能也有帮助。
