Differential Diagnosis for Vivid Visual Hallucinations of Animals

• Single most likely diagnosis
  • Charles Bonnet Syndrome: This condition is characterized by vivid, complex visual hallucinations, often of animals or people, in individuals with significant visual impairment. The hallucinations are typically benign and not associated with other psychotic symptoms.
• Other Likely diagnoses
  • Peduncular Hallucinosis: A rare condition caused by lesions in the peduncular region of the midbrain, leading to vivid visual hallucinations, often of animals.
  • Lewy Body Dementia: A neurodegenerative disorder that can cause visual hallucinations, often of animals or people, in addition to cognitive decline and parkinsonian symptoms.
  • Psychotic Disorders (e.g., Schizophrenia): While less common, vivid visual hallucinations can occur in psychotic disorders, although they are typically accompanied by other symptoms such as delusions, disorganized thinking, and negative symptoms.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Meningitis or Encephalitis: Infections that can cause visual hallucinations, among other symptoms, and require prompt medical attention to prevent serious complications or death.
  • Temporal Lobe Seizures: Seizure activity in the temporal lobe can cause visual hallucinations, and if left untreated, can lead to status epilepticus or other severe consequences.
• Rare diagnoses
  • Hallucinogenic Persisting Perception Disorder: A rare condition where individuals experience persistent visual hallucinations, including seeing animals, after using hallucinogenic drugs.
  • Neurosyphilis: A rare infection that can cause visual hallucinations, among other symptoms, if left untreated.