Formed Visual Hallucinations as Digitalis Toxicity

Excerpt

While the cardiac symptoms of digitalis excess are well known and their recognition is facilitated by data on the serum digitalis level, the noncardiac neurologic symptoms of digitalis toxicity may precede the arrhythmia and obscure the diagnosis (1, 2). We report the cases of three patients who had digitalis intoxication and an unusual central nervous system toxic manifestation, formed visual hallucinations. The lack of electrocardiographic clues and the failure to recognize that hallucinations may be associated with digitalis toxicity resulted in delayed diagnosis. The apparitions experienced by our patients were more complex than the scotomas, flashing geometric patterns, zigzags, or