TY - JOUR
T1 - Visual, Tactile, and Phobic Hallucinations
T2 - Recognition and Management in the Emergency Department
AU - Pao, Maryland
AU - Lohman, Cheryl
AU - Gracey, Dorothy
AU - Greenberg, Larrie
PY - 2004/1
Y1 - 2004/1
N2 - Objectives: The purposes of this case series are to review the acute manifestations of hallucinatory phenomenon in young children, with a focus on visual, tactile, and phobic hallucinations (VTPH) as an important part of the differential diagnosis; and to describe 10 children who presented to the Children's National Medical Center Emergency Department (CNMC ED) with VTPH. Methods: The medical records of children identified with VTPH who were evaluated during a 20-month period in 1998 to 1999 were reviewed. The diagnosis was established if the hallucinations were well documented as being anxiety-related, not auditory, and with no evidence of underlying organic etiology. All cases were initially screened in the emergency department. Demographic information included age, gender, duration, and description of symptoms, stressors, family psychiatric history, and outpatient treatment. Results: Ten children with this disorder were encountered. VTPH can be differentiated from other causes of hallucinations in that the children are preschool to young school age; their hallucinations are tactile and visual, presenting at night; and symptoms are anxiety-based but short-lived. When toxins, drug reactions, central nervous system, and febrile etiologies are ruled out, timely consultation with the psychiatry team can eliminate costly and time-consuming procedures and avoid further emotional distress for the child and family. Conclusions: VTPH is a more commonly occurring disorder than previously reported in the pediatric emergency medicine literature. Emergency physicians who recognize the characteristics of this diagnosis are encouraged to seek psychiatric consultation rather than performing unnecessary and costly diagnostic tests.
AB - Objectives: The purposes of this case series are to review the acute manifestations of hallucinatory phenomenon in young children, with a focus on visual, tactile, and phobic hallucinations (VTPH) as an important part of the differential diagnosis; and to describe 10 children who presented to the Children's National Medical Center Emergency Department (CNMC ED) with VTPH. Methods: The medical records of children identified with VTPH who were evaluated during a 20-month period in 1998 to 1999 were reviewed. The diagnosis was established if the hallucinations were well documented as being anxiety-related, not auditory, and with no evidence of underlying organic etiology. All cases were initially screened in the emergency department. Demographic information included age, gender, duration, and description of symptoms, stressors, family psychiatric history, and outpatient treatment. Results: Ten children with this disorder were encountered. VTPH can be differentiated from other causes of hallucinations in that the children are preschool to young school age; their hallucinations are tactile and visual, presenting at night; and symptoms are anxiety-based but short-lived. When toxins, drug reactions, central nervous system, and febrile etiologies are ruled out, timely consultation with the psychiatry team can eliminate costly and time-consuming procedures and avoid further emotional distress for the child and family. Conclusions: VTPH is a more commonly occurring disorder than previously reported in the pediatric emergency medicine literature. Emergency physicians who recognize the characteristics of this diagnosis are encouraged to seek psychiatric consultation rather than performing unnecessary and costly diagnostic tests.
KW - Hallucinations
KW - VTPH
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U2 - 10.1097/01.pec.0000106240.72265.2d
DO - 10.1097/01.pec.0000106240.72265.2d
M3 - Review article
C2 - 14716163
AN - SCOPUS:0347763454
SN - 0749-5161
VL - 20
SP - 30
EP - 34
JO - Pediatric emergency care
JF - Pediatric emergency care
IS - 1
ER -