Hallucinations

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Background

  • The perception of auditory, visual, tactile, or gustatory sensations without an actual stimulus
  • Etiology may be from underlying psychiatric disorder or organic cause.

Clinical Features

Differential Diagnosis

Hallucinogens

Sedative/hypnotic toxicity

Dissociative drugs

Other Organic Causes

Psychiatric Causes [1]

Evaluation

  • Workup should be targeted toward specific diagnosis. Cranial imaging generally only indicated for focal neurological findings or headache red flags
  • In non-auditory hallucinations, assume organic pathology until proven otherwise.
  • If concern for suicidal or unknown toxic ingestion:
    • Acetaminophen level
    • Salicylate level
    • ECG

Management

  • Treat the underlying pathology.
  • In the case of alcohol withdrawal hallucinosis, no standard therapy has been established,[2] although treatment with neuroleptics (e.g. Haldol) has shown some benefit. [3] Also continue to treat the alcohol withdrawal.

See Also

References

  1. Visual Hallucinations: Differential Diagnosis and Treatment. PMID PMC2660156
  2. Neuroleptic treatment of alcohol hallucinosis: case series. PMID 18030655
  3. Alcohol-induced hallucinosis. Clinical aspects, pathophysiology and therapy. PMID 9064548