Hallucinations: Difference between revisions
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''In non-auditory hallucinations, assume organic pathology until proven otherwise.'' | ''In non-auditory hallucinations, assume organic pathology until proven otherwise.'' | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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*Treat the underlying pathology. | *Treat the underlying pathology. | ||
*In the case of Alcohol Withdrawl Hallucinosis, no standard therapy has been established,<ref> Neuroleptic treatment of alcohol hallucinosis: case series. PMID: 18030655</ref> although tx with neuroleptics (e.g. Haldol) has shown some benefit. <ref>Alcohol-induced hallucinosis. Clinical aspects, pathophysiology and therapy. PMID=9064548</ref> Also continue to treat the [[Alcohol Withdrawl |alcohol withdrawal]]. | *In the case of Alcohol Withdrawl Hallucinosis, no standard therapy has been established,<ref> Neuroleptic treatment of alcohol hallucinosis: case series. PMID: 18030655</ref> although tx with neuroleptics (e.g. Haldol) has shown some benefit. <ref>Alcohol-induced hallucinosis. Clinical aspects, pathophysiology and therapy. PMID=9064548</ref> Also continue to treat the [[Alcohol Withdrawl |alcohol withdrawal]]. | ||
==See Also== | ==See Also== | ||
Revision as of 18:56, 7 April 2014
Background
- The perception of auditory, visual, tactile, or gustatory sensations without an actual stimulus
- Etiology may be from underlying psychiatric disorder or organic cause.
In non-auditory hallucinations, assume organic pathology until proven otherwise.
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 [1]
- Schizophrenia
- Schizo-affective Disorder
- Dementia
- Delirium
- Migraine
- Seizure
- Parkinson's Disease
- Charles Bonnet Syndrome (in the visually impaired)
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,[2] although tx with neuroleptics (e.g. Haldol) has shown some benefit. [3] Also continue to treat the alcohol withdrawal.