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Acta Neurológica Colombiana

Print version ISSN 0120-8748On-line version ISSN 2422-4022

Abstract

RAMIREZ-GARCIA, Sergio; TOVAR-ALARCON, Marcela; DUENAS-GARCIA, Friedrich  and  TORRES-LOPEZ, César Daniel. Peduncular hallucinosis in multiple sclerosis, a rare symptom in demyelinating disease. Acta Neurol Colomb. [online]. 2023, vol.39, n.4, e7.  Epub Nov 03, 2023. ISSN 0120-8748.  https://doi.org/10.22379/anc.v39i4.866.

Introduction:

Peduncular hallucinosis (PA) refers to self-discriminating hallucinations, these are caused by lesions in the midbrain and pons.

Presentation of the case:

27-year-old right handed female patient with visual and auditory hallucinations self-discriminated by the patient, with no prior history of importance and with lesions in cerebral and cervical Magnetic Resonance in the superior cerebellar peduncle, pontine tegmentum, and in the cervical spine with pattern 2 oligo clonal bands, which met Mc Donald's criteria for multiple sclerosis.

Discussion:

Peduncular hallucinosis refers to the presence of visual hallucinations criticized by the patient, consequence of lesions in the inhibitory pathways with deafferentation and disinhibition of the midbrain-thalamic and retinogeniculus-calcarine pathways. Described as a manifestation of multiple neurological pathologies such as trauma, vascular, tumor and few cases of demyelinating among others.

Conclusion:

Peduncular hallucinosis is an atypical form of presentation of pontomesencephalic lesions described in several pathologies, it must be taken into account when locating the neurological lesion, few cases have been reported as symptom of the demyelinating disease.

Keywords : Hallucinations; Demyelinating Diseases; Multiple Sclerosis; Visual Perception; Diencephalon; Brain Stem.

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