Abstract

The goal of this article was to review the literature on visual hallucinations (VH) and, more specifically, the association of visual perceptual disorders with age, specific pathologies that are etiologically related to the VH, the anatomical location of the pathology, and the relation of the characteristics of the VH to the pathology and location of the lesions and, in addition, the importance of insight in the differential diagnosis of the VH. A total of 45 articles, representing 117 cases dating from 1940 to 1991, were reviewed. This review, although relying on information provided retrospectively, includes cases of VH from all disciplines and attempts to identify characteristics associated with this disorder. Our review does show an increased frequency of VH in the elderly, with almost 50% of the case reports in the past 50 years occurring in patients in their seventh and eighth decades. There was a large differential diagnosis of VH and there may be multifactorial causality. Eye pathology was the most frequent association with VH in patients over age 60 in our review, with cataracts accounting for over half of the cases reported within this group. Our review confirms that VH can occur as a result of a lesion anywhere within the visual perceptual system—from the lens to the association cortex.

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