Ballard C, McKeith I, Harrison R, O'Brien J, Thompson P, Lowery K, Perry R, Ince P
Neurochemical Pathology Unit, Newcastle General Hospital, Newcastle Upon Tyne, England.
Int Psychogeriatr. 1997 Dec;9(4):381-8. doi: 10.1017/s1041610297004523.
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.
视幻觉（VH）是路易体痴呆（DLB）的核心特征，但对其现象学了解甚少。对73名接受临床服务的痴呆患者（42名DLB患者、30名阿尔茨海默病[AD]患者、1名未确诊患者）使用详细的标准化量表进行了评估。DLB根据McKeith及其同事的标准进行诊断，AD使用NINCDS-ADRDA标准进行诊断。尽可能获得尸检确认。VH采用Burns及其同事的定义。记录了幻觉体验的详细描述。进行了年度随访访谈。19例进行尸检的病例中有18例临床诊断得到证实。共有93%的DLB患者和27%的AD患者出现视幻觉。DLB患者更有可能出现多种持续存在于随访期间的视幻觉。他们更有可能听到视幻觉说话，但在其他现象学特征方面没有显著差异，包括幻觉是否移动、出现的时间、大小、洞察程度以及是否完整。DLB患者的视幻觉可能更易出现多种、会说话且持续存在。这些特征可能有助于准确诊断。
