Differential Diagnosis for Visual Hallucinations

Single most likely diagnosis

• Neurodegenerative disorders (e.g., Parkinson's disease, Lewy body dementia, Alzheimer's disease): Visual hallucinations are a common feature in these conditions, particularly in Lewy body dementia, where they are a hallmark symptom.

Other Likely diagnoses

• Psychotic disorders (e.g., schizophrenia): Visual hallucinations can occur in psychotic disorders, although auditory hallucinations are more common.
• Seizure disorders (e.g., temporal lobe epilepsy): Some seizure disorders can cause visual hallucinations, especially those involving the temporal lobe.
• Migraines: Certain types of migraines, such as ocular or visual migraines, can cause visual hallucinations.
• Substance-induced psychosis: Certain substances, such as LSD or other hallucinogens, can cause visual hallucinations.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed)

• Intracranial infections (e.g., meningitis, encephalitis): These conditions can cause visual hallucinations and require prompt treatment to prevent serious complications or death.
• Brain tumors: Certain brain tumors, such as those in the temporal lobe, can cause visual hallucinations.
• Vascular disorders (e.g., stroke, vasculitis): Visual hallucinations can be a symptom of a stroke or other vascular disorders, which require immediate medical attention.

Rare diagnoses

• Charles Bonnet syndrome: A condition that causes visual hallucinations in people with visual impairment or blindness.
• Peduncular hallucinosis: A rare condition caused by lesions in the peduncle of the midbrain, leading to visual hallucinations.
• Hallucinogenic persistent perception disorder: A rare condition where visual hallucinations persist after the use of hallucinogenic substances has stopped.