Hallucinations: Difference between revisions
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*The perception of auditory, visual, tactile, or gustatory sensations without an actual stimulus | *The perception of auditory, visual, tactile, or gustatory sensations without an actual stimulus | ||
*Etiology may be from underlying psychiatric disorder or organic cause. | *Etiology may be from underlying psychiatric disorder or organic cause. | ||
==Clinical Features== | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 37: | Line 37: | ||
==Diagnosis== | ==Diagnosis== | ||
''Workup should be targeted toward specific diagnosis. Cranial imaging is only useful if localized neurological findings or [[Headache Red Flags | headache red flags]] '' | ''Workup should be targeted toward specific diagnosis. Cranial imaging is only useful if localized neurological findings or [[Headache Red Flags | headache red flags]] '' | ||
''In non-auditory hallucinations, assume organic pathology until proven otherwise.'' | |||
*If concerned for suicidal or unknown toxic ingestion: | *If concerned for suicidal or unknown toxic ingestion: | ||
**Aspirin | **Aspirin | ||
**Tylenol level | **Tylenol level | ||
**ECG | **ECG | ||
==Management== | ==Management== | ||
Revision as of 12:28, 1 June 2015
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
Organic Causes
- Alcohol Withdrawal - hallucinosis without altered sensorium, predominately auditory & usually begins 24-48 hours after last drink
- Anticholinergic Toxicity
- Hallucinogen Intoxication
- Psilocybin/Mushroom Poisoning
- LSD
- Mescaline (Peyote)
- Ecstasy (MDMA)
- PCP
- Bath Salts
- Salvia Intoxication
- Marijuana
- Methanol Toxicity
- Tricyclic (TCA) Toxicity
- GHB Intoxication
- Ertapenem Toxicity
- Encephalitis
- Hypocalcemia/Hypercalcemia
Psychiatric Causes [1]
- Schizophrenia
- Schizo-affective Disorder
- Dementia
- Delirium
- Migraine
- Seizure
- Parkinson's Disease
- Charles Bonnet Syndrome (in the visually impaired)
Diagnosis
Workup should be targeted toward specific diagnosis. Cranial imaging is only useful if localized neurological findings or headache red flags In non-auditory hallucinations, assume organic pathology until proven otherwise.
- 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.