Abstract
Peduncular hallucinosis is a rare syndrome that develops with upper brainstem and diencephalon lesions. Patients complain of vivid hallucinations that usually occur in hypnagogic states but maintain critical appraisal. Pathological disruption of the reticular activating systems partially explains this clinical phenomenon. We report the case of a 47-year-old man presenting with peduncular hallucinosis associated with central auditory disturbance consisting of bilateral hypoacusis and left-sided paradoxical hyperacusis, secondary to a pontine haemorrhage.
Highlights
Peduncular hallucinosis is a rare syndrome that was first described by Lhermitte in 1922 in a patient with oculomotor palsy who presented with vivid, dream-like visual hallucinations associated with a hypnagogic state
We report the case of a 47-year-old man with an intracerebral haemorrhage due to a pontine cavernoma presenting with peduncular hallucinosis and bilateral hypoacusis associated with paradoxical hyperacusis
The patient described represents a rare case of a pontine haemorrhage presenting with hallucinosis and central auditory manifestations consisting of hypoacusis associated with paradoxical hyperacusis
Summary
Peduncular hallucinosis is a rare syndrome that was first described by Lhermitte in 1922 in a patient with oculomotor palsy who presented with vivid, dream-like visual hallucinations associated with a hypnagogic state. Auditory and tactile hallucinations have since been reported in association, suggesting the involvement of a more complex network [3]. We report the case of a 47-year-old man with an intracerebral haemorrhage due to a pontine cavernoma presenting with peduncular hallucinosis and bilateral hypoacusis associated with paradoxical hyperacusis. This case report was prepared according to CARE guidelines [5]. The hallucinations and hearing abnormalities subsided to some degree throughout the hospital stay and were still present at 3 months follow-up
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