cqvip:Visual hallucinations (VHs) occur frequently in Parkinson’s disease (PD). VHs occur more frequently in elderly patients with longer duration of illness, cogn itive impairment, and sleep disturbances. The relationship between the use of an tiparkinsonian drugs and VHs is complicated, but most drugs used to treat parkin sonian motor symptoms induce VHs and psychosis in some PD patients. The “contin uum hypothesis”proposing that medication induced psychiatric symptoms in PD be gin with drug induced sleep disturbances, followed by vivid dreams, with progre ssion to hallucinatory and delusional experiences has been challenged. In some p atients, VHs may represent intrusion of REM sleep related imagery into wakefuln ess. Improving REM sleep abnormalities in PD (e.g., stimulants, anticholinestera se inhibitors) is one strategy now being tested to improve VHs in PD.
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