Late-onset persistent visual hallucinations with epileptiform discharge

Area of Science:

• Neurology
• Neurophysiology
• Psychiatry

Background:

• Late-onset visual hallucinations can be challenging to diagnose.
• Epileptiform discharges on electroencephalography (EEG) are typically associated with seizures.
• The presentation of visual hallucinations without other overt seizure symptoms is uncommon.

Purpose of the Study:

• To report a unique case of late-onset visual hallucinations associated with epileptiform EEG discharges.
• To investigate the potential link between epileptiform activity and visual hallucinations.
• To evaluate the efficacy of sodium valproate in treating this condition.

Main Methods:

• Case report of a 58-year-old female.
• Electroencephalography (EEG) to detect brain activity.
• Clinical observation of visual hallucinations and neurological status.
• Treatment with sodium valproate.

Main Results:

• The patient presented with abrupt, persistent visual hallucinations.
• EEG revealed prominent epileptiform discharges (diffuse sharp and slow wave complex).
• No other psychotic symptoms or epileptic seizures were observed.
• Epileptiform discharges resolved within 20 days of sodium valproate treatment.
• Clinical improvement of hallucinations correlated with EEG improvement.

Conclusions:

• Late-onset visual hallucinations can be associated with underlying epileptiform activity.
• Sodium valproate may be an effective treatment for visual hallucinations linked to epileptiform discharges.
• The etiology of these hallucinations may involve organic factors, warranting further investigation.