Complex nocturnal visual hallucinations

Background and purpose: To describe the clinical features and associations of complex nocturnal visual hallucinations. Patients and methods: We identified 12 patients seen between 1997 and 2004 with complex nocturnal visual hallucinations. Charts were reviewed and data analyzed. Results: Of the 12 patients, 11 were women. Vivid, silent, often distorted images of people and animals occurred after waking, disappearing with increased light. Idiopathic hypersomnia, beta blocker use, dementia with Lewy bodies, macular degeneration and anxiety were associated factors. The hallucinations appeared to be a primary parasomnia in four patients with anxiety being the only associated feature. Conclusions: Complex nocturnal visual hallucinations represent a well-defined syndrome with diverse causes which should be differentiated from other parasomnias causing arousals. (c) 2005 Elsevier B.V. All rights reserved.