ANA: A Good Ghost Story Deserves a Neurological Exam

CHICAGO, Oct. 13 -- Vivid ghost stories recounted by apparently healthy patients may be a sign of somatic neuropathology, researchers reported here.

In a poster presentation at the American Neurological Association meeting here, Japanese clinicians reviewed a case of a 60-year-old man who said he had developed severe insomnia three years earlier along with difficulty writing and dealing with numbers.

But what particularly distressed the man was that he had begun to have frequent visual hallucinations, both in the daytime and at night, reported Hirokazu Furuya, M.D., of the University of Kyushu School of Medicine, and colleagues.

"In one incident," Dr. Furuya said, "the man described being at home when all of a sudden six men burst into his living room and began cooking. He asked them who they were and what they wanted, but he received no response. When he tried to get their attention by tapping the figures on their shoulder, the apparition and all the others vanished."

Another time, he was on his way to the bathroom in the middle of the night when, in a thoroughly darkened hallway, he came across the mortally stabbed body of his wife. Despite the darkness he could see bright red blood bubbling from a gaping neck wound. As he tried to help her, she vanished at his touch. "His wife remains very much alive and has never been stabbed," Dr. Furuya said.

The patient was examined by a psychologist who could find no particular mental problems.

A neurologic workup revealed no bradykinesia; no muscle rigidity, and no finger tremors, There was, however, Balint's syndrome, which is characterized by optic ataxia and optic apraxia, and agraphia and dyscalculia, which both affect mathematical calculations. His mini-mental state exam was 17/30.

An MRI revealed atrophy of the bilateral parieto-occipital, occipital, and left temporal cortex. A computer-assisted tomography scan also detected decreased blood flow in the parietal and frontal regions.

"We think that it is possible that the lack of blood flow and the atrophy of these brain areas somehow is triggering these 'ghost' appearances," Dr. Furuya said.

He suggested that if patients relate these vivid 'ghost' stories, scanning studies are warranted. "We should take these cases seriously and not just dismiss them as unimportant hallucinations if we see no other outward signs that could have caused these visions," he said.

Dr. Furuya said the visions reported by the patient fits into ghost stories that are in common circulation in Japanese folklore, of which 151 have been collected in a database. He said that patients who see these visions are rare - but perhaps they are more common than most doctors suspect.