A 22-year-old college student reports a peculiar visual disturbance that causes images to persist even after their corresponding stimulus has ceased.
Which of the following symptoms best suits the above description?
B. Palinopsia (palin for ‘again’ and opsia for ‘seeing’). is a visual disturbance that causes images to persist even after their corresponding stimulus has ceased. It is seen in LSD use, migraine, occipital epilepsy, and head trauma. It is similar to afterimage but colour inversion (usually shadows or distorted colours) noted in afterimages is conspicuously absent. Formication (formic acid – from ants) is a special type of haptic hallucination. It is often an unpleasant sensation of little animals or insects crawling under the skin, seen in delirium tremens and cocaine intoxication.
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A 54-year-old man who is living at a psychiatric rehabilitation home complains of seeing his own image outside his body.
Which of the following is the commonest psychiatric cause of this phenomenon?
C. Autoscopic hallucinations are the visual experience of seeing oneself. It is seen predominantly in males compared to females at a ratio of 2:1. Impaired consciousness is a common accompaniment and depression is the commonest psychiatric cause of autoscopy. They are also called phantom mirror images and may take the form of pseudohallucinations. Schizophrenia (where autoscopic experience is usually pseudohallucinatory), TLE, and parietal lesions (organic states more likely to have true hallucinations) are also implicated. In negative autoscopy one looks into a mirror and sees no image at all.
Which of the following drugs on withdrawal produce disturbed proprioceptive perceptions?
D. Chronic benzodiazepine use leads to the development of dependence, with a characteristic withdrawal syndrome that presents with anxiety and agitation, insomnia, tremor, depersonalization, and, if severe, can lead to seizures and delirium. Kinaesthetic or proprioceptive hallucinations refer to joint or muscle sense, often linked to bizarre somatic delusions. Kinaesthetic hallucinations are seen in benzodiazepine withdrawal and alcohol intoxication.
A patient, whose right arm was amputated following a crush injury, suffers from recurrent, tactile sensations arising out of the lost limb.
Which of the following symptoms is this description classified as?
C. The common experience of phantom limb is a body image disturbance and not a hallucination; though it is in external space, it does not satisfy other qualities of hallucination and patients are usually aware of unreality. It is a body image disturbance with a neurological basis.
Which of the following is an extracampine hallucination?
A. Extracampine hallucinations are hallucinations that occur outside the normal field of perception, for example images seen behind your back, under your sternum, or hearing voices from Inverness, etc. (if you are not living in Inverness, of course!). They occur in schizophrenia, epilepsy, and also in hypnagogic hallucinations of healthy people – so they are not diagnostically important.
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