Hallucinations: Difference between revisions
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*The perception of auditory, visual, tactile, or gustatory sensations that are not present | *The perception of auditory, visual, tactile, or gustatory sensations that are not present | ||
*Etiology may be from underlying psychiatric disorder or organic cause. | *Etiology may be from underlying psychiatric disorder or organic cause. | ||
''In non-auditory hallucinations, assume organic pathology | ''In non-auditory hallucinations, assume organic pathology until proven otherwise.'' | ||
==Clinical Features== | ==Clinical Features== |
Revision as of 17:40, 28 March 2014
Background
- The perception of auditory, visual, tactile, or gustatory sensations that are not present
- Etiology may be from underlying psychiatric disorder or organic cause.
In non-auditory hallucinations, assume organic pathology until proven otherwise.
Clinical Features
Differential Diagnosis
Organic Causes
- Alcohol Withdrawal - hallucinosis without altered sensorium, predominately auditory & usually begins 24-48 hours after last drink
- Anticholinergic Toxicity
- GHB Intoxication
- Mushroom Poisoning
- Bath Salts
- Tricyclic (TCA) Toxicity
- Methanol Toxicity
- Salvia Intoxication
- Ertapenem Toxicity
- Encephalitis
Psychiatric Causes
- Schizophrenia
- Dementia
- Parkinson's Disease
Workup
Workup should be targeted toward specific diagnosis. Cranial imaging is only useful if localized neurological findings or headache red flags
- If concerned for suicidal or unknown toxic ingestion:
- Aspirin
- Tylenol level
- ECG
Management
- Treat the underlying pathology.
- In the case of Alcohol Withdrawl Hallucinosis, no standard therapy has been established,[1] although tx with neuroleptics (e.g. Haldol) has shown some benefit. [2] Also continue to treat the alcohol withdrawal.