Is it normal to have hallucinations after a stroke?

8 answers | Last updated: Apr 30, 2018
Caty76 asked...

My grandma has started having hallucinations since her Cerebral Vascular Accident (stroke). Is there anything we can do to help? Is it normal?


Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

In summary, yes, and yes.

A stroke can injure parts of the brain involved in keen awareness of the surroundings, spatial perception, and cognition.  If any of these aspects of brain functioning are damaged, the person often loses their ability to function normally, or to adapt to any small changes in environment.  It is quite frequent, as the brain ages or gets damaged, for people to become confused, hallucinate, etc., particularly when it gets into evening or nighttime hours, or if they are in strange surroundings.  Also, these people tend to lose their standard sleep/wake cycle patterns, and can be up at night with paranoid delusions.  A classic example would be an elderly stroke victim complaining that "there are people in the house who are stealing my things".

Fortunately, you can help.  First, you can try regulating the environment, keeping her in a very comforting, stable environment.  You can try to regulate her sleep/wake cycles by encouraging her not to take naps, to make sure she voids all urine before going to bed (to minimize nighttime waking to use the bathroom), and possibly even using gentle sleep aids to help her sleep at night.

Additional steps, if these initial steps fail, would include seeking the help of a Psychiatrist or starting anti-psychotic medications.  Often, these medicines are very effective in cutting down on the frequency of psychotic delusions.


Community Answers

A fellow caregiver answered...

Look at the correlation between stroke and theta waves or hypnagogia. Theta is the brain wave frequency common to strokes, slower that regular waking states, where hallucinations or hypnagogic images are exessive.


Tiredbutsmiling answered...

My father began seeing children (we referred to them as "winkies" and he used me for reality checks, which helped him laugh them off) which eventually passed. the brain was partially starved for a short time -- the effect of the CVA -- and it takes a while to heal. Another blip concerning hallucinations came within a week of starting Aricept, which his doctor put him on almost immediately. My father would wake up after going to sleep and "see" things like a child handing him a flower. Aricept does increase REM pressure, which might account for some of the night time problems.

For months after the stroke, he slept a lot.... but that eventually decreased to normal levels.
Read Stroke of Insight by Jill Bolte Taylor....


Jainnagraj answered...

Nine months back my wife had a stroke.Initially she had only physical disability. After six months we noticed her mental disability too.She is sort of in a dream all the time.She is experiencing hallucinations.Some time she is very normal some time all of a sudden she becomes abnormal. There are ups and downs.Memory loss may be reason for all this sort of things.


Marciasheart answered...

I am not sure my mom had a stroke, I believe so. She had a fall where she did not put out her hands to brace the impact and her face took the entire force. We went to urgent care and nothing was broken. Now she is seeing demons in her room at night. She 'fights' them with her cane I fear she will break a window or mirror and cut herself.


Clalvis answered...

My 59 y.o. husband had his third stroke two years ago and has been having hallucinations about the neighbors being in the house and messing with him. He gets to the point where he has to leave the house because he's unable to handle them. He pulls the covers over his head so he doesn't see them. I've had to rent an Extended Stay Hotel so that he and I can have a peace of mind. He has been subscribed Soroquel, but doesn't want to take it because people thinks he's crazy.


Shebasgram answered...

I can't find how to ask a question on here so I'll ask here. For the past month or so, every week or so my husband goes through a day and a half (this last episode lasted 3 days and nights) of visual hallucinations, confusion, and walking around like a tired old man. He'll lay awake all night, sleeping very little, having conversations with people who aren't there and making hand and arm movements like he's eating or performing some task. After the episode is over, he sleeps for 12 to 24 hours, waking only to use the urinal or when I bring his meals up to him. Then suddenly he's back to normal. Afterwords when I talk to him about it, he remembers most of what was going on but claims that he really was seeing the people or the ants or bugs that he said were there. Once he even asked for his brothers phone number and I had to remind him that his brother has been dead for years. He's also confused about where my daughter is (who lives with us). At times, he doesn't have a clue where he is. He was in the bedroom and said that we had to leave because 'they' would be closing soon. We are in the process of testing; the doctor is trying to find out if it's true dementia common in older folks, or some affect of escalating CHF that he's had for 20 years (diastolic now systolic also), something to do with his kidney function (also has CKF for 10 years, or vascular dementia due to years of severe hypertension or some other cause. Do you have any suggestions as to what could cause these episodic symptoms with the times in between where he is completely normal?


Kg101190 answered...

I'm only 27 and had a stroke about a month and a half ago (due to my blood no longer being produced correctly from chronic chemical exposure, meaning it can no longer transport oxygen efficiently enough for my brain to get it). I also have an erratic heart, so it never seems to know what it wants to do. One moment my BP is very low and HR is high (normal), and then either my heart rate will drop or my BP will go extremely high for no reason at all. While I was having the stroke it was at 155/115 with a HR of 120. That's when I suddenly couldn't walk at all and everything else went to hell as well. Thankfully I was already on my way to a room right after that happened. Ever since then my Narcolepsy has gotten significantly worse, MOST noticeably with my night-time hallucinations and severe insomnia. I'm unable to fall asleep for 4-5 nights in a row every week and a half or so, but it's getting worse. It started off with me closing my eyes and within 5-10 seconds being in a dream where I'm still in my bed, but there's something in front of me or beside me, or I want to find something that isn't there, so I'll start reaching for it until several moments later I realize it's not there because my hand's going straight through it, or because I'll be trying to grab it (like a cigarette that I drop every time in the "dream,") and just keep pulling on something that won't seem to move, so I realize I'm dreaming and open my eyes to find myself acting it out, sometimes violently, but the object will still be there until I close and then open my eyes again. It makes it to where I can only get a total of 30-40 seconds of "sleep," (narcoleptic sleep as bad as mine isn't truly sleep, because I'm just hallucinating with my eyes closed but I'm still fully awake and aware of my surroundings. If I keep my eyes open I just hallucinate, and for the first time during my life literally had a full 30 minute dream with my eyes wide open, as if I was watching a movie, but I was half asleep... but it wasn't accompanied by paralysis like narcoleptic hypnogognic hallucinations usually are. All I can say is I have dealt with Narcolepsy for over a decade, and severe sleep disorders before that my entire life (they all just developed into Narcolepsy, which is how it usually begins), and that stroke intensified them and they are continuing to get worse. I believe they may get better after several months, but hell knows. It's absolutely ridiculous now, and I can only hope they at least get back to where they were pre-stroke, even though that was still horrible, but I'm used to it. I'm NOT used to this, though. Good luck!