VISUAL HALLUCINATIONS ASSOCIATED WITH PARKINSON DISEASE

Objective: To determine factors that are predictive for the developmen t of hallucinations associated with Parkinson disease (PD). Background : Hallucinations are a common difficulty for patients with established PD, and hallucinations and psychosis may be the most common causes fo r nursing home placement. The characteristics of the hallucinations as sociated with PD differ from the hallucinations associated with schizo phrenia or cocaine abuse. Multiple factors have been suggested as caus al. Design and Methods: A total of 214 consecutive patients were inter viewed during routine visits to the Parkinson's Disease Clinics in Col umbus, Ohio, and Miami, Fla, using a hallucination questionnaire, Fols tein Mini-Mental State Examination, and an attempt to correlate age, d uration of disease, medication, and psychological or sleep disorders w ith the hallucinations. Results: Hallucinations were almost exclusivel y visual and were present in 55 of the 214 patients. Demential age, du ration of disease, history of depression, or history of sleep disorder were strongly associated with the hallucinations. Conclusions: While reduction in levodopa and anticholinergic medication doses is appropri ate in the management of hallucinations, the factors that predispose p atients to hallucinations include dementia and advancing age. The phen omena of visual hallucinations associated with PD, while not fully exp lained, are unique enough to be of interest to all neurologists and ne uroscientists.