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A need for a common language for Altered Persisting Visual Perceptions

Published on January 7, 2012 by in HPPD

The research and clinical community must not hinder the ability for the disciplines to communicate common symptoms in the same language. An excellent example is the wonderful work from the K Internet searchers where keywords are used for developing relationships between articles.

Kawasaka et al. (196) reports three clinical cases of HPPD patients in the Archives of Ophthalmology. Three patients with HPPD symptoms in the clinic with common symptoms and test results. The authors’  provide one common explanation for the lack of knowledge with diagnosing HPPD patients as the lack of shared terminology among related disciplines for the same experience: “1) Palinopsia (and the trailing variant) as a symptom of hallucinogen use is not present in the neurologic or ophthalmologic literature. The only notable case in ophthalmologic literature reporting visual illusions from hallucinogen use were Levi and Miller (1990),” the authors state, “palinopsia, as well as other chronic visual disturbances from LSD, has been well detailed in the psychiatric literature… One possible reason for this discrepancy may be differences in descriptive terminology. Psychiatrists do not use the term palinopsia; instead, they refer to this symptom as ‘aflerimagery’ or ‘visual flashbacks.’”

With over thousands of pages of text collected from the HPPDonline.com database and similar websites we can mine for common use words from HPPD members, visual snow, and related disorders we can determine words commonly used by patients and seek to develop an instrument with face validity aimed to develop construct validity.

All references are cited in Bibliography.

 

 
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Vision Simulator for Demonstrating “Starbursting”

 

Dr. Roger Davis, a close friend and co-author of other vision simulators on this site, has an amazing simulator for private use on his website www.visionsimulations.com.

http://www.visionsimulations.com/index.php?option=com_content&task=view&id=56&Itemid=149

 

I created an image to represent what I see:

 
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First Livestream Discussion of HPPD and Altered Visual Perception Disorders

Members of the HPPD and Visual Snow community have posted many questions about HPPD on their support web site, and some of these questions are directed to me and you have not received answers.

My thesis text “Characterization of Hallucinogen Persisting Perception Disorder” has one final form bound in the library, and because of the dynamic discussions with Dr. Henry David Abraham and new information coming to light, the text is a puzzle of about 400 pages of text. Eventually, I plan to complete the text. I will include the updated information from my oral debates and as new information is submitted to me and to submit it for online publication.

My solution, which is in lieu of answering 500 odd e-mails, is to use a new way to communicate to the HPPD community as a group. First, to give a lecture regarding the the current state of HPPD, and the disorders with similar symptom profiles, via Live streaming video with interactive chat.You will be able to log in and ask questions during the presentation and I will take questions towards the end. Additionally, users will be able to share their own answers in a common moderated chat room.

The first livestream is scheduled for January 7th at 5:00 PM Eastern Standard Time

To access the livestream you can visit the www.facebook.com/hppdonline or go directly to the stream at http://www.ustream.tv/channel/visiondisorders The discussion has been entered as an event on ustream and is an open invitation.

I will be advertising this event via twitter and other social networking sites targeting researchers and allowing for any interested media or science authors to take part. I hope to have members of the psychedelic research community to participate as well.

I expect the lecture to last 30 minutes to 1 hour depending on the group’s interest. Documents related to the discussion will be posted to allow users to engage in their own research and fact checking on my work. Interactive polling is available to quickly get an opinion from the group on a topic at a given moment.

I hope this will give the community their first view of another HPPD member and to create the largest HPPD gathering to discuss this disorder and the future for research, treatment, and diagnosis.

Sincerely,

David S. Kozin

Twitter: @davidkozin

To view my resume/cv: David Kozin Resume

 

 

 

 

 
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My qEEG Report. Evidence for Persisting Visuals

Link to PDF File: DavidKozinQeeGResults

 

LETTER TO PATIENT FROM PRIMARY PHYSICAN
I have received the full quantitative EEG report from Dr. *****’s lab at Children’s Hospital. As I suspected, it is not a normal study. Generally, it shows electrical abnormalities, particularly in the posterior region of the nervous system, and particularly in the visual evoked potential study, a measure of visual function. The good news is that this is consistent with HPPD, and indicated no other ongoing problem, such as epilepsy. I am enclosing a copy for your records.

MEDICAL RECORD FROM NEUROPHYSIOLOGY
LABORATORY: Children’s Hospital, Boston,
Massachusetts
BRAIN ELECTRICAL ACTIVITY MAPPING (BEAM)
QUANTITATIVE ELECTROENCEPHALOGRAM (qEEG)

This report consists of 5 parts:
• ELECTROENCEPHALOGRAM ANALYSIS and ELECTROENCEPHALOGRAM
IMPRESSION
• SPIKE TOPPOGRAPHY IMPRESSION
• SPECTRAL ANALYSIS and SPECTRICAL IMPRESSION
• EVOKED POTENTIALS ANALYSIS and EVOKED POTENTIALS IMPRESSION
• SUMMARY OF FINDINGS
ELECTROENCEPHALOGRAM IMPRESSION

In the waking, eyes closed state this is 1 hour and 6 minutes record reveals 11 Hz well developed symmetrical and reactive occipital alpha atop otherwise low amplitude background. There is a well developed anterior-posterior gradient. Anteriorly, the experienced amounts of beta and theta are seen for age. In mild drowsiness on two occasions, a low amplitude spike is seen in the left parietal region. No other discharges are seen. Well developed stage 2 sleep is seen with symmetrical spindle and vertex waves. Throughout the photic stimulation fails to activate
discharges but shows a normal driving response. Stimuli used to form evoked potentials do not activate discharges. Hyperventilation shows age appropriate buildup but without activation of seizure discharges.
Ctenoids or 14 & 6 bursts are noted in the right temporal region (T6)

Electroencephalogram Impression
A borderline record due to the appearance of two low amplitude spikes in the left parietal (P3) electrode in drowsiness and light sleep. Otherwise waking and sleep background are normal. Alpha is well developed. The normal variant rhythm of ctenoids (14 and 6) is noted.

SPIKE TOPOGRAPHY
Spike Topography Impression
Ctenoids (14 and 6) are noted in the right posterior temporal electrode (T6). Occasional left parietal (P3) low amplitude spikes are documented.

SPECTRAL ANALYSIS
The walking, eyes closed record reveals delta and theta to be the maximal in the central vertex region. Alpha is seen in the parietal and central regions as well as in the occipital region left more then right. Betas 2 and 3 are seen to be maximal in the occipital region right more that left. Beta 3 is seen to be artifact dominated. In comparison to an age appropriate normal database theta is increased by 3.49 SD broadly in the frontal and central regions without asymmetry.
Spectral analysis of the EEG background in the eyes close state reveals delta to be maximal in the occipital region. Theta is seen to be maximal in the central vertex region. Alpha and the beta spectral bands are seen to be maximal in the occipital region. In comparison to an age appropriate normal database, Theta is increased by 2.56 SD bilaterally in the fronto-central region with no asymmetry. Alpha is seen to peak at 22 Hz (mean alpha peak for age is 10 Hz).
The relative (%) spectral data are within normal limits. The symmetry function is within normal limits.

Spectral Analysis Impression:

An abnormal EEG spectral background due to excessive bifrontal and central theta with no evident asymmetry. Also is seen to peak at 11 Hz, 1 Hz above mean for age.

EVOKED POTENTIALS

The VER to flash stimuli shows very high amplitude response with very prominent late time locked alpha. In comparison to an age appropriate normal database from 68-104 msec there is broadly but symmetrically increased posterior negativity by 6.08 SD. From 288-324 msec there is excessive posterior positively by 2.87 SD. From 340-376 msec there is increased biposterior positively by 5.09 SD also related to time locked alpha. The AER to click stimulate shows very normal morphology although the P2 component is slightly delayed. Amplitudes are overall normal. In comparison to an age appropriate normal database from 216-252 msec the delayed P2 shows excessive central positively by 2.64 SD

Evoked Potential Impression
A very abnormal flash VER with extremely high amplitude posterior activity but without asymmetry. In contrast the click AER is quite normal in morphology although the P2 is slightly delayed. Thus the AER is borderline.

SUMMARY OF FINDINGS
The brain EEG is borderline due to two left parietal (P3) low amplitude spikes. Otherwise waking and sleep background are within normal limits. Spike topography confirms the P3 spike foci.Sprectral data are surprisingly abnormal with consistently excessive fronto-central theta.
Alpha is seen to peak at 1 Hz fast for age 11 Hz. the VER to flash stimuli is extremely high amplitude, whereas, the click AER is of normal amplitude. No EP asymmetries are noted, however.

Overall this is an abnormal study. The astoundingly high amplitude VER amplitude, the fast alpha, and the left parietal spikes may somehow be related to the patient’s hallucinations. Spikes always raise the possibility of a seizure disorder; however, such occipital over reactivity may be associated with post-substance abuse hallucinations short of frank seizures. The front theta raises the possibility of a mild encephalopathic process as well.

*********, MD

This qEEG was reprinted with the permission of the patient (AKA Me).


 

 

 
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DPD/DR from Marijuana: In their own words.

 

My DP/DR began one night when I was smoking the last bit of weed that my friend and I had. We made the smallest joint on this planet. Seriously, it was real pathetic. Anyway, I smoked it with him, and everything in the room started turning all red. I started freaking out and told him I wanted to go to the hospital. This was the first time I had ever requested going to a hospital over a drug like this. Somehow this scared me even more than my LSD experience. Anyway, I finally calmed down hours later, and stayed home. The next morning I felt better, but a little off. I’d say a month after that the DP/DR just hit me. My arms and hands didn’t seem like mine, and my reflection just didn’t seem right. It’s never been the same since then (7 years ago).

After about a year, I felt a lot better. To the point where I was totally fine in the world. I decided I wanted to lose some weight, so I started jogging with a friend of mine. I was jogging every single day for 2 miles. I was eating almost nothing. I lost weight REAL fast, and started getting days where I was real dizzy due to not eating. Somehow from doing this, it amplified my DP/DR that had pretty much gone away. It amplified it to the point where I finally decided to seek help. I saw this moron of a doctor (I call him a moron because he never listened to me, and told me to do what he said without giving my input…) who perscribed me Paxil CR 12.5mg for agoraphobia. I explained to him I thought I was having the agoriphobia because of the DP/DR, not the other way around. He never even had heard of DP/DR if I recall…

Anyway, the Paxil made me feel awesome the first day. I found it funny because he said it would take a while to kick in. I felt so great the first day I was actually able to go out and do things with my wife. I remember thinking, “wow, I can finally live again!” The next day came, and the Paxil CR wore off about 2 hours before I was to take my next dose. I remember waves of panic crashing through me, and it almost took me to my knees (I was standing.) I finally took the Paxil again, but it didn’t really help after that. From there on out it was downhill with the Paxil. Crazy stuff starting happening. I would wake up in the middle of the night and not recognize my wife. I would be saying in my head over and over again: “That’s Nichole… That’s Nichole…) and I started getting thoughts that just weren’t mine. I remember my wife and I were standing in a fabric store talking to someone, and I just had this thought to grab the scissors out of his hand and stab him in the neck. The second I thought that in my head I was like: “What the hell is my problem!” I went outside to walk around, but never really felt better. I called my doc and told him I was losing sleep, having thoughts that wern’t mine, and really felt like it was making me worse. He told me there’s no way the medicine could be doing it, because it hadn’t been long enough yet, and that it was just my symptoms becoming worse. He recomended upping the dosage. I can’t remember what I told him, but I never upped the dosage. Months had gone by (maybe around 4 or 5) and I was still feeling really bad. I remember I left work and was on my way to the local fast food joint for lunch and I noticed that I was feeling really good. I was like: “Wow, I think I’m finally starting to feel better!” I got my lunch, ate, and then looked at the clock. It was hours past the time I was supposed to take my Paxil. After that I threw the pills in the toilet, and quit cold turkey. I felt AWESOME as the next few weeks went by. Now fast forward to present, and I seem to be getting worse again. My neurologist wants me to take Lexapro (another SSRI…yea, as if you guys don’t know that…) and he keeps trying to convince me that another SSRI might not give me the same bad results. I haven’t tried it yet. I was seeing the neurologist for another problem, and the only thing he found wrong with my brain is apparently I have “enlarged ventricals” whatever that means. He thinks it’s just normal for my brain. I had another MRI done about a year later, and they hadn’t gotten any bigger. He says to get another one done in 2 or 3 years to make sure it doesn’t change, and if it doesn’t then to just drop it all together.

I get very little sleep. I find myself waking up all the damn time in the night. I wake up and feel like I have never gone to sleep during the night.

I also took ritalin as a kid because my parents said I had (at the time it was called ADD) ADHD. However, they said they took me off of it because they tried me on it, and on a placebo and I acted the same.

OK, now that I’m sure I’ve totally bored you with all of this, please figure this stupid thing out! Why is it when the brain malfunctions, it always malfunctions towards evil??

Anyway, if you want me to elaborate on anything, or have more questions, I will be more than happy to help you guys out.

Good luck guys, and I’m extactic that someone is actually working on this. I plan on donating to your site once you get everything up and running.

One more thing (I’m trying to think of everything I can…) my Dad was recently diagnosed with MS. I don’t know if it’s genetic or what… but hey, if it fits some corrolation somewhere… who knows. It’s 1 AM where I am… I’m off to sleep …

 
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