Hallucinations: Difference between revisions

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*[[General Psych Workup]]
*[[General Psych Workup]]
*[[Alcohol Withdrawal]]
*[[Alcohol Withdrawal]]
*[[Hallucinogens]]


==Sources==
==Sources==

Revision as of 06:43, 19 December 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

  1. Alcohol Withdrawal - hallucinosis without altered sensorium, predominately auditory & usually begins 24-48 hours after last drink
  2. Anticholinergic Toxicity
  3. Hallucinogen Intoxication
    1. Psilocybin/Mushroom Poisoning
    2. LSD
    3. Mescaline (Peyote)
    4. Ecstasy (MDMA)
    5. PCP
    6. Bath Salts
    7. Salvia Intoxication
    8. Marijuana
  4. Methanol Toxicity
  5. Tricyclic (TCA) Toxicity
  6. GHB Intoxication
  7. Ertapenem Toxicity
  8. Encephalitis
  9. Hypocalcemia/Hypercalcemia

Psychiatric Causes [1]

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.

See Also

Sources

  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
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