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HALLUCINATIONS


It is a type of abnormal perception.
Definition:
A hallucination is a perception experienced in the absence of an external stimulus. The hallucinations can be auditary. Visual, olfactory, visual, olfactory, gustatory or tactile domains.
Hallucinations can be of organic origin i.e due to organic disease of the nervous system or may be due to extreme environmental disturbances as in sensory deprivation.
 Auditary hallucinations are commonest types of hallucinations in non-organic psychiatric disorders.
The hallucination is experienced much like a true perception and it seems to come from an external objective space.
 He the hallucination does not either appear to be a true perception or comes from a subjective internal space then it is called a pseudohallucination.

Second person voices.
Second person voices with distressing content _' you stink, you are horrible, in kill yourself, are found in severe depressive illness.

Third person voices
patient feels that someone is discussing about him or are commenting on what he is doing., these are suggestive of schizophrenia in the absence of organic brain disease.

Visual hallucinations
visions of people or animals.
Hallucinations can occur when going to sleep called hypnagogic, or while getting up from the bed when it is called hypnopompic.

ORGANIC HALLUCINOSIS
the following features are required for the diagnosis of organic hallucinosis.
1. Persistent or recurrent hallucinations due to an underlying organic cause. Usually the patient realize that the hallucinations are not real but sometimes there may be a delusional elaboration of hallucinations.
2. On major disturbance of combints intelligence, memory, mood or thought.

Aetiology.
1. Drugs : LSD, cocaine, cannabis, levodopa, bromocriptine.
2. Alcohol
3.sensory deprivation.
4. 'release ' hallucinations due to sensory pathway disease, e.g. Bilateral cataracts, otosclerosis, optic neuritis.
5. Migraine.
6. Epilepsy:complex partial seizures.
7. Intracranial space occupying lesions.
8. Temporal arteritis.
9. Brain stem lesions.

Treatment.
1. Treatment of the underlying cause, if treatable.
2. Symptomatic treatment with a low dose of an antipsycotic medications may be needed.

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