Abstract:
Visual hallucinations in Parkinson\'s disease (PD) are usually attributed to medications and dysfunction in higher order sensory processing as the disease progresses. However deficits in visual processing, including colour discrimination, have been reported in early, untreated PD and it is unclear how these, along with co-morbid conditions affecting vision, could contribute to hallucinations. This case describes a 66-year-old otherwise fully independent woman with early, mild PD who presented with discrete episodes of unusual vivid hallucinations centred on colour. She was later found to have a subclinical colour deficiency in excess of her PD and, after reporting a lifelong history of poor vision in her father, tested positive for autosomal dominant optic atrophy. This case illustrates how a lifelong extrinsic deficiency in colour vision can interact with the effects of visual changes in early stage PD and medication to provoke colour hallucinations. It therefore emphasises the importance of full ophthalmological work up in similar cases where hallucinations are atypical and unexpected for the severity and stage of PD.
摘要:
帕金森病(PD)的视觉幻觉通常归因于药物治疗和随着疾病进展的高级感觉处理功能障碍。然而视觉处理的缺陷,包括肤色歧视,早期就有报道,未经治疗的PD,目前还不清楚这些,以及影响视力的合并症,可能会导致幻觉。这个案例描述了一个66岁的完全独立的女人,轻度PD,表现为以颜色为中心的不寻常生动幻觉的离散发作。后来发现她患有超过PD的亚临床颜色缺乏症,在报告了她父亲一生的视力不良史之后,常染色体显性视神经萎缩检测呈阳性.这个案例说明了终身的外在色觉缺陷如何与早期PD和药物治疗中的视觉变化的影响相互作用,从而引起颜色幻觉。因此,它强调了在类似情况下进行全面眼科检查的重要性,在这种情况下,幻觉对于PD的严重程度和阶段是非典型且出乎意料的。