Peduncular hallucinosis : An unusual presentation of isolated bilateral pontine infarction

Peduncular hallucinosis (PH) is a rare neurological disorder, characterized by visual hallucinations, and often associated with sleep and oculomotor disturbances. It is typically due to thalamic and brainstem lesions. We report here the case of a 69-year-old patient, with personal history of depression, diabetes and hypertension, presenting with complex auditory and visual hallucinations associated with insomnia but without oculomotor abnormalities. Brain MRI revealed isolated bilateral symmetric paramedian upper pontine ischemic lesions, which are likely to be the cause of this PH. This case could expand the etiological spectrum of PH, adding bipontine infarction to the list of lesions responsible for this rare condition.