HALLUCINATION AND RISK FACTORS IN PATIENTS WITH PARKINSON’S DISEASE

Yıl 2019, Cilt: 21 Sayı: 3, 388 - 394, 31.12.2019

Bahar Say , Yasemin Ünal Tuğba Tunç Gülnihal Kutlu , Ufuk Ergün

https://doi.org/10.24938/kutfd.619939

Öz

Objective: Hallucination is one of the non-motor symptoms in
Parkinson disease (PD). Several factors may affect the presence of
hallucination. In the present study, we aimed to compare PD patients presenting
with and without hallucinations, to determine risk factors, and to find out
common hallucination types.

Material and Methods: Idiopathic Parkinson patients regarding to UK
Parkinson Disease Society Brain Bank with and without hallucinations were
compared. The patients with psychotic symptoms due to metabolic, infectious, and structural causes were
excluded. Disease severity was evaluated by Unified Parkinson Disease Rating Scale and Hoehn and Yahr staging.
Cognitive status was assessed by Minimental State Examination test. Depression
was diagnosed on the basis of DSM-V Tr. Description of hallucination,
treatment, co-morbidity, sleep disturbances, REM sleep behavioral disorder,
age, gender, scores of test and scale, stage of disease were recorded.

Results: A total of 91 (59 female, 32 male) patients with idiopathic PD were enrolled. The group with hallucinations
(Group 1) had 40 (43.9%) patients and the one without hallucinations (Group 2)
had 51 (54.9%) patients. Total score of Unified
Parkinson Disease Rating Scale was significantly higher in Group 1 than
Group 2 (37.83±16.65; 30.18±14.83; p=0.028). Sleep
disturbances were high in Group 1 (n=24, 60%) when compared to Group 2 (n=14,
27.4%) (p=0.007). The mean duration of
hallucinations was 24.87±56.47 months in Group 1. Twenty-one patients (23.9%)
had visual hallucinations; 15 (16.5%) patients had illusions (minor
hallucinations); and four (4.4%) patients had auditory hallucinations.

Conclusion: Disease severity in Parkinson's disease may be a
factor in the presence of hallucinations. Hallucinations may also occur with
sleep disorders. Minor hallucinations are frequently observed in early stages,
with visual hallucinations being the most common hallucinations that may occur
in every disease stage.

Anahtar Kelimeler

Minor hallucination, visual hallucination, disease severity, sleep

Destekleyen Kurum

None

Parkinson Hastalarında Halusinasyon ve Risk Faktörleri

Öz

Amaç: Halusinasyon Parkinson
hastalığındaki non-motor semptomlardan biridir. Halusinasyon varlığında birçok risk
faktörü rol oynayabilir. Bu çalışmada halusinasyonu olan ve olmayan Parkinson
hastalarının karşılaştırılması, risk faktörlerinin belirlenmesi, sık görülen
halusinasyon tiplerinin bulunması amaçlandı.

Gereç ve Yöntemler: İngiltere Beyin Bankası
kriterlerine gore idiopatik Parkinson hastalığı tanısı olan hastalarda
halusinasyonu olan ve olmayanlar karşılaştırıldı. Metabolik, enfeksiyöz ve
yapısal nedenlere bağlı psikotik semptomu olan hastalar çalışmaya dahil
edilmedi. Hastalık şiddeti Birleşik Parkinson Hastalığı Değerlendirme Ölçeği ve
Hoehn ve Yahr evrelemesine göre belirlendi. Kognitif durum Minimental Durum
Değerlendirme testi ile değerlendirildi. Depressif duygu durum tanısı DSM-5 ile
konuldu. Mevcut ise halusinasyon tanımlaması, tedavi, komorbidite, uyku
bozuklukları, REM uyku davranış bozukluğu, yaş, cinsiyet, ölçek ve test
skorları ile hastalık evresi kayıt edildi.

Bulgular: Çalışmaya toplam 91 (59 kadın,
32 erkek) idiopatik Parkinson hastası alındı. Halusinasyonu olan grup (Grup 1)
da 40 (%43.9), halusinasyonu olmayan grupta (Grup 2) 52 (%54.9) hasta vardı.
Birleşik Parkinson Hastalığı Değerlendirme Ölçeği toplam skoru Grup 1 de Grup 2
ye göre anlamlı oranda yüksekti (37.83±16.65; 30.18±14.83; p=0.028). Uyku
bozuklukları Grup 2 (n=14, %27.4) ile karşılaştırıldığında Grup 1’de (n=24, %60) anlamlı oranda yüksekti (p=0.007). Halusinasyon süresi
Grup 1’de ortalama 24.87±56.47 aydı. 21 (%23.9) hasta görsel halusinasyon, 15 (%16.5)
hasta illuzyon (minör halusinasyon) ve dört (%4.4) hasta işitsel halusinasyona
sahipti.

Sonuç: Parkinson hastalığında hastalık şiddeti
halusinasyon varlığında etken olabilir. Halusinasyonlar uyku bozuklukları ile
birlikte görülebilir. Minör halusinasyonlar sıklıkla erken evrede izlenirken,
en sık görülen görsel halusinasyon her evrede izlenebilir.

Anahtar Kelimeler

Minör halusinasyon, görsel halusinasyon, hastalık şiddeti, uyku

Kaynakça

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