What Causes Speech And Depth Perception Difficulties With Visual Hallucinations?

Posted on Tue, 15 May 2018

Question: My husband has had an onset of the following starting in late July: Difficulty choosing words / difficulty speaking. Lack of depth perception/misjudging motions with hands and feet. Started out with him telling me when he closes his eyes everything would turn red and then green. He experiences some confusion and loss of sense of direction like being able to go to the bathroom at the store and know where to go when he comes out. Is being seen by a neurologist who says to get a second opinion because he doesn't know what to do. Has had a carotid doppler. Ultrasound of the heart. Both to check for blockage. Both negative. Also has had two MRI's - one with contrast and one without. Also negative. Waiting to see the new neurologist but can't get in until XXXXXXX 12th. Some people think maybe this could be some sort of auto immune disease. I am at a loss as to what to do and scared to death.

Answered by Dr. Ishu Bishnoi (1 hour later)

Brief Answer:
Need more information and possible differential diagnosis

Detailed Answer:
Hi Fxxxx.gxxxxxxx, thanks for asking from HCM.

I can understand your concern. Your husband symptomatology is suggesting altered higher mental functions especially judgement ability, language. He is also experiencing confusion and visual hallucinations. Such manifestations at his age (53 years) could be due to neurological disorder like

- Early onset of Alzheimer disease

- Ischemic dementia

- Diffuse cerebral atrophy

- Metabolic/alcoholic encephalopathy

- Damage of frontal and parietal lobe (traumatic/tumor/ischemic/auto-immune/age related/degenerative)

- Multivitamin deficiency like B12, folic acid, vitamin E

- Thyroid dysfunction (hypothyroidism)

- Psychological illness like depression or psychosis

To conclude something, I need to know more about him. Please provide me answers of following questions like

- How is his memory? Is he forgetting names/places/date also?

- Is there any history of long term alcohol and tobacco intake?

- Is there any past history of significant head injury?

- Is he a diabetic/hypertensive?

- Is there any history of abusive behaviour/urination in clothes/total change in personality?

- Is there any history of mental stress?

I hope you will understand my point. Please ask your neurologist to check his higher mental functions like memory, judgement ability, language, empathy, thought process, abstract thinking and all. It will confirm the degree of dementia.

If you have any doubts, do let me know.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Yogesh D