Hostname: page-component-6bf8c574d5-qdpjg Total loading time: 0 Render date: 2025-02-24T08:40:55.064Z Has data issue: false hasContentIssue false
  • English
  • Français

Visual Hallucinations on Eye Closure Associated with Atropine Toxicity. A Neurological Analysis and Comparison with other Visual Hallucinations

Published online by Cambridge University Press:  18 September 2015

C. Miller Fisher
C. Miller Fisher*
Affiliation:
Neurology Service Massachusetts General Hospital, Boston, Massachusetts
*
Neurology Service, Massachusetts General Hospital, Boston, MA, USA 02114
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Visual hallucinations of remarkable intensity began shortly after intravenous atropine and persisted for 11 days. They were present only when the eyes were closed and were associated with heightened dreaming and disturbed sleep. The patient remained lucid and described his experiences to his attendants. Our patient's hallucinations bore some resemblance to hypnagogic hallucinations and this became the basis for the hypothesis that the hallucinations originated in the sleep-dream system of the brain stem. It is speculated that a similar site — a metabolic locus minoris resistentiae may play a part in other types of visual hallucinations and in delirium.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 18 , Issue 1 , February 1991 , pp. 18 - 27
Copyright
Copyright © Canadian Neurological Sciences Federation 1991

References

1.Goodman, LS, Gilman, A, eds. The Pharmacological Basis of Therapeutics, 5th Edition. New York: MacMillan, 1985; 572.Google Scholar
2.de Morsier, G. Les hallucinations. Ètude oto-neuro-ophtalmologique. Rev Oto-neuro-ophtal 1938; 16: 241–352.Google Scholar
3.Hècaen, H, Badaraco, JG . Semeiologie des hallucinations visuellesen clinique neurologique. Acta Neurol Latinoamer 1956; 2: 23–57.Google Scholar
4.West, LJ, ed. Hallucinations. New York and London: Grune & Stratton, 1962.mGoogle Scholar
5.Duke-Elder, WS. Text-Book of ophthalmology, Vol. 12. St. Louis: C.V. Mosby Company, 1971.Google Scholar
6.Rozanski, J. Peduncular hallucinosis following vertebral angio-graphy. Neurology 1952;2:341–349.CrossRefGoogle Scholar
7.Burgermeister, JJ, Tissot, R, de Ajuriaguerra, J. Les hallucinations visuelles des ophtalmopathes. Neuropsychologia 1965; 3: 9–38.CrossRefGoogle Scholar
8.Kölmel, HW. Complex visual hallucinations in the hemianopic field. J Neurol Neurosurg Psychiatry 1985; 48: 29–38.Google ScholarPubMed
9.Sherrington, CS. Man on his nature, 2nd Edition. New York: Doubleday & Company, 1953.Google Scholar
10.Maury, MA. Des hallucinations hypnagogiques ou des erreurs des sens dans l’état intermédiare entre la veille et le sommeil. Ann Médico-Psychol 1848; 11: 26–40.Google Scholar
11.Fisher, CM. Neurologic fragments II. Remarks on anosognosia, confabulation, memory and other topics; and an appendix on selfobservation. Neurology 1989; 39: 127–132.CrossRefGoogle Scholar
12.Vihvelin, H. On the differentiation of some typical forms of hypnagogic hallucinations. Acta Psychiat Neurol 1948; 23: 359–389.Google Scholar
13.Hobson, JA. The dreaming brain. New York: Basic Books, 1988.Google Scholar
14.Hobson, JA, McCarley, RW. The brain as a dream state generator. An activation-synthesis hypothesis of the dream process. Amer J Psychiat 1977; 134: 1335–1348.Google ScholarPubMed
15.Hobson, A. Sleep mechanisms and pathophysiology: some clinical implications of the reciprocal interaction hypothesis of sleep cycle control. Psychosomatic Med 1983; 45: 123–140.CrossRefGoogle ScholarPubMed
16.Hishikawa, Y, Kaneko, Z. Electroencephalographic study on narcolepsy. Electroencephalogr Clin Neurophysiol 1965; 18: 249–259.CrossRefGoogle Scholar
17.Lhermitte, J. Désordre de la fonction hypnique et hallucinations. Ann MéDico-Psychol 1938; 1: 1–14.Google Scholar
18.Abraham, HD. Visual phenomenology of the LSD flashback. Arch Gen Psychiat 1983; 40: 884–889.CrossRefGoogle ScholarPubMed
19.Hauge, T. Catheter vertebral angiography. Acta Radiologica Suppl 1954; 109: 1–219.Google ScholarPubMed
20.Nakajima, K. Clinicopathological study of pontine hemorrhage. Stroke 1983; 14: 483–493.CrossRefGoogle ScholarPubMed
21.Fisher, CM. The pathologic and clinical aspects of thalamic hemorrhage. Trans AM Neurol Assoc 1959; 84: 56–59.Google ScholarPubMed
22.Chavany, JA. Referred to by de Morsier.2Google Scholar
23.Feinberg, WM, Rapcsak, SZ. ‘Peduncular hallucinosis’ following paramedian thalamic infarction. Neurology 1989; 39: 1535–1536.Google ScholarPubMed
24.Flournoy, H. Le cas de Charles Bonnet: Hallucinations visuelles chez un vieillard operé de la cataracte. Arch Psychol Suisse 1901; 1: 1–23.Google Scholar
25.Abell, T. Remarkable case of illusive vision. Boston Med Surg 1845;33:409–413.Google Scholar
26.Flournoy, H. Atypical lilliputian hallucinations in an old man with cataract. Encephale 1923; 18: 566–579.Google Scholar
27.Weinberger, EA, Grant, FC. Visual hallucinations and their neurooptical correlates. Arch Ophthalmol 1940; 23: 166–199.CrossRefGoogle Scholar
28.Bartlett, JEA. A case of organized visual hallucinations in an old man with cataracts and their relation to the phenomenon of the phantom limb. Brain 1951; 74: 363–373.Google Scholar
29.Ormond, AW. Visual hallucinations in sane people. Br Med J 1925; 2: 376–378.Google Scholar
30.Vignaendra, V, Loh, TG, Lim, CL, et al. Epileptic discharges triggered by blinking and eye closure. Electroencephal Clin Neurophysiol 1976;40:491–498.CrossRefGoogle ScholarPubMed
31.Cogan, DG. Visual hallucinations as release phenomena. von Graefes Arch Klin Ophthalmol 1973; 188: 139–150.Google ScholarPubMed
32.Lamy, H. Hemianopsie avec hallucinations dans la partie abolie du champ de la vision. Rev Neurol 1895; 3: 129–135.Google Scholar
33.Lance, JW. Simple formed hallucinations confined to the area of a specific visual field defect. Brain 1976; 99: 719–734.CrossRefGoogle Scholar
34.Geller, TJ, Bellur, SN. Peduncular hallucinosis: Magnetic resonance imaging confirmation of mesencephalic infarction during life. Ann Neurol 1987; 21: 602–604.CrossRefGoogle ScholarPubMed
35.Engerth, G, Hoff, H, Pötzl, O . Zur patho-physiologie der hemianopischen Halluzinationen. Ztschr Ges Neurol Psychiat 1935; 152: 399–421.Google Scholar
36.Brust, JCM, Behrens, MM. “Release Hallucinations” as the major symptom of Posterior Cerebral Artery Occlusion: a report of 2 cases. Ann Neurol 1977; 2: 432–436.CrossRefGoogle Scholar
37.Terson, A. Hallucinations visuelles chez des ophtalmopaths. Ann d’oculiste 1930; 167:815–825.Google Scholar
38.Lhermitte, J. Syndrome de la calotte de pedoncule cerebral. Les troubles psycho-sensoriels dans les lesions du mesoncephale. Rev Neurol 1922; 29: 1359–1365.Google Scholar
39.Baruk, MH. Les hallucinations visuelles. Paris: Bull Soc Opthal, 1936;8:713–739.Google Scholar
40.Maron, L, Rechtschaffen, A, Wolpert, EA. The sleep cycle during napping. Arch Gen Psychiat 1964; 11: 503–508.Google ScholarPubMed
41.Foulkes, D, Vogel, G. Mental activity at sleep onset. J Abnorm Psychol 1965;70:231–243.CrossRefGoogle ScholarPubMed
42.Jackson, H. The factors of insanities. Medical Press and Circ 1894; 57:615–619.Google Scholar
43.Jackson, JH. Selected Writings of Hughlings Jackson. Taylor, J, Homes, G and Walshe, FMR, eds. New York: Basic Books, 1958; 2:421.Google Scholar
44.Mettler, CC. History of Medicine; A correlative text, arranged according to subjects. Philadelphia Blakiston 1947; 552.Google Scholar
45.Wolff, HG, Curran, D. Nature of delirium and allied states. Arch Neurol Psychiat 1935; 33: 1175–1215.CrossRefGoogle Scholar
46.Tabakoff, B, Munoz-Marcus, M, Fields, JZ. Chronic ethanol feeding produces an increase in muscarinic cholinergic receptors in mouse brain. Life Sci 1979; 25: 2173–2180.Google ScholarPubMed
47.Nordberg, A, Wahlstrom, G, Larsson, C. Increased number of muscarinic binding sites in brain following chronic barbiturate treatment to rat. Life Sci 1980; 26: 231–237.CrossRefGoogle ScholarPubMed