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Hallucinations | Doctor's Diary

Hallucinations are common in dementia, and potentially have very many causes. When I hear about hallucinations, the first thing that I want to know is the stage of dementia in which it is occurring. If I hear that hallucinations are occurring in someone with Alzheimer's disease , I expect that they should be in the severe or perhaps in the moderate stage. If it is happening in someone with mild dementia, I consider that they have Dementia with Lewy Bodies until proven otherwise. The reason to take that approach is that it makes me try and avoid drugs known as neuroleptics. These drugs often work well in someone with hallucinations. However, a person who has Dementia with Lewy Bodies can get very severe side effects, known as the neuroleptic sensitivity syndrome, if they are given neuroleptics. Another thing to consider is delirium, which is a sudden change in their cognitive status; when hallucinations are present, delirium often results in the person being very agitated.

Not all hallucinations are due to dementia or delirium. They can be seen in depression , and also in a condition known as the Charles Bonnet Syndrome. In that syndrome, hallucinations occur in a person who has poor vision. What happens is that the brain tries to make sense of the limited visual information that it gets by building unreal images (often of very small people). Usually, people who have the Charles Bonnet Syndrome have good insight into the unreality of theirhallucinations.

See Also:
About Dementia > Treatments for Dementia > Adverse Drug Reactions
About Dementia > Alzheimer's Disease > Agnosia
Symptom Library > Thinking & Judgment > Comprehension/ Understanding
Symptom Library > Physical Changes > Sensory Input
Symptom Library > Behaviour > Delusions and Paranoia
About Dementia > Types of Dementia > Dementia with Lewy Bodies
About Dementia > Types of Dementia > Delirium
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Last updated December 7, 2018
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