Visual complaints and visual hallucinations in Parkinson's disease

Urwyler, Prabitha; Nef, Tobias; Killen, Alison; Collerton, Daniel; Thomas, Alan; Burn, David; McKeith, Ian; Mosimann, Urs Peter (2014). Visual complaints and visual hallucinations in Parkinson's disease. Parkinsonism & related disorders, 20(3), pp. 318-322. Elsevier 10.1016/j.parkreldis.2013.12.009

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Background
Visual symptoms are common in Parkinson's disease (PD) and are frequently under-diagnosed. The detection of visual symptoms is important for differential diagnosis and patient management.

Aim
To establish the prevalence of recurrent visual complaints (RVC) and recurrent visual hallucinations (RVH) and to investigate their interaction in PD patients and controls.

Methods
This cross-sectional study included 88 PD patients and 90 controls. RVC and RVH were assessed with a visual symptom questionnaire and the North-East-Visual-Hallucinations-Interview (NEVHI).

Results
Double vision (PD vs. Controls: 18.2% vs. 1.3%; p < 0.001), misjudging objects when walking (PD vs. Controls: 12.5% vs. 1.3%; p < 0.01), words moving whilst reading (PD vs. Controls: 17.0% vs. 1.3%; p < 0.001) and freezing in narrow spaces (PD vs. Controls: 30.7% vs. 0%; p < 0.001) were almost exclusively found in PD patients. The same was true for recurrent complex visual hallucinations and illusions (PD vs. Controls: both 17.0% vs. 0%; p < 0.001). Multiple RVC (43.2% vs. 15.8%) and multiple RVH (29.5% vs. 5.6%) were also more common in PD patients (both p < 0.001). RVC did not predict recurrent complex visual hallucinations; but double vision (p = 0.018, R2 = 0.302) and misjudging objects (p = 0.002, R2 = 0.302) predicted passage hallucinations. Misjudging objects also predicted the feeling of presence (p = 0.010, R2 = 0.321).

Conclusions
Multiple and recurrent visual symptoms are common in PD. RVC emerged as risk factors predictive of the minor forms of hallucinations, but not recurrent complex visual hallucinations.

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5 Citations in Web of Science ®
6 Citations in Scopus

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