Multiple hallucinations due to brainstem injury: A case report

Abstract

We report a case of a 43-year-old woman with brainstem encephalitis in the third trimester of pregnancy. She presented complex visual and auditory hallucinations in the acute disease phase (hearing opera arias and seeing room furniture upside-down). Hallucinations resolved with antiviral treatment.

Unexpected Improvement of Hand Motor Function with a Left Temporoparietal Low-Frequency Repetitive Transcranial Magnetic Stimulation Regime Suppressing Auditory Hallucinations in a Brainstem Chronic Stroke Patient

“…Following a hallucinatory relapse after 2 months off-rTMS treatment, 22 additional rTMS sessions led once more to a complete abolition of AHs. Several single case or cohort clinical studies have reported the occurrence of AHs in stroke patients with either cortical, thalamic or brainstem damage ( 3 – 7 ). Furthermore, poststroke AHs are often caused by a lesion of the auditory pathway encompassing the pons, the thalamus, or temporal lobe regions ( 21 ).…”

“…Furthermore, poststroke AHs are often caused by a lesion of the auditory pathway encompassing the pons, the thalamus, or temporal lobe regions ( 21 ). These symptoms usually emerge in the acute phase of the stroke ( 3 – 7 ). Yet, cases of delayed-onset psychotic event similar to the one discussed in this report have been reported either several months or even years following a right temporoparietal stroke ( 22 , 23 ).…”

“…Stroke patients can often develop neuropsychiatric symptoms such as depression (61% of cases), eating disorders (33%), anxiety (23%) or psychosis, i.e., delusion (2%), and hallucinations (1%) ( 1 ). Clinical reports have described in patients suffering acute strokes in the cortex, the thalamus or the brainstem, insidious visual ( 2 , 3 ), and/or auditory hallucinations (AHs) ( 3 – 7 ).…”

Hearing disorders in brainstem lesions

“…Additional reports have been published since, under variable terminology: peduncular hallucinations, brainstem hallucinosis, and auditory illusions (Table 29.5). Sometimes the hallucinations are musical, as in the case reported by Silva and Brucki (2010), consisting of a continuous repetition of a Carmen Habanera aria. In a few cases the patient experienced both auditory and visual hallucinations (Cambier et al, 1987;Taylor et al, 2005;Silva and Brucki, 2010), although the auditory component is the predominant one.…”

“…Sometimes the hallucinations are musical, as in the case reported by Silva and Brucki (2010), consisting of a continuous repetition of a Carmen Habanera aria. In a few cases the patient experienced both auditory and visual hallucinations (Cambier et al, 1987;Taylor et al, 2005;Silva and Brucki, 2010), although the auditory component is the predominant one. Of the reported 20 cases, 14 lesions (70%) were localized in the pontine tegmentum ( Fig.…”