The study by Sanchez-Ramos et al1 delineates a number of factors that predict the development of hallucinations in patients with Parkinson disease. Complex visual hallucinations occurred in more than 55 (25%) of the study population of 214 consecutive patients with PD and they were strongly associated with age, dementia, disease duration, depression, and sleep disorders. The absence of detailed ophthalmological evaluation in these patients precluded an accurate estimate of visual loss that is an important cause of visual hallucinations. Complex hallucinations have been reported in 22 (21%) of 104 consecutive patients with retinal and neural afferent visual pathway lesions causing trivial to profound visual loss.2 Cogan3 has conjectured that such hallucinations stem from ongoing cerebral activity of the visual system and are released by removal of normal visual input. Along with neurological disorders, toxic and metabolic abnormalities, psychiatric disorders, and miscellaneous conditions, including sleep disturbances and sensory
Lepore FE. Visual Loss as a Causative Factor in Visual Hallucinations Associated With Parkinson Disease. Arch Neurol. 1997;54(7):799. doi:10.1001/archneur.1997.00550190005001
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