The hallucinations were not vague flickers or shapes at the edge of vision. A 56-year-old Japanese woman saw and heard the King of Hell. She developed delusions of jealousy, then delusions of possession, accompanied by impulsive and violent behavior. Her thinking declined.
The cause was not a psychiatric illness. It was a small blood vessel malformation in her right thalamus, discovered incidentally 18 years earlier and left alone because surgery had not been feasible at the time.
