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EMI – mixed topics
Published in Bhaskar Punukollu, Michael Phelan, Anish Unadkat, MRCPsych Part 1 In a Box, 2019
Bhaskar Punukollu, Michael Phelan, Anish Unadkat
1. B, D. Alcohol withdrawal and depression: Alcohol withdrawal – (i) Usually begins 12–48 hours after cessation of drinking, (ii) Common symptoms include tremor, weakness, sweating, and nausea, (iii) Seizures occur less commonly. Alcoholic hallucinosis – (i) Follows a period of abstinence after heavy chronic drinking, (ii) Characterized by auditory hallucinations usually persecutory or threatening in nature, (iii) Symptoms may last for days and can be controlled with antipsychotic drugs such as chlorpromazine.
Psychiatry
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
alcoholic hallucinosis: rare conditions in which auditory hallucinations occur alone in clear consciousnessusually clears in a few days, but may be followed by secondary delusional misinterpretationup to 50% go on to develop symptoms of schizophrenia (Benedetti, 1952)
Therapeutic Uses and Side Effects
Published in Fazal-I-Akbar Danish, Ahmed Ehsan Rabbani, Pharmacology in 7 Days for Medical Students, 2018
Fazal-I-Akbar Danish, Ahmed Ehsan Rabbani
Non-psychiatric indications: Tourette’s syndrome.Non-manic excited states.To control disturbed behaviour in Alzheimer’s disease.Migraine.Alcoholic hallucinosis.Nausea and vomiting.Intractable hiccup.Persistent pruritus.Pre-operative sedation.To potentiate the effects of analgesics.
Clarithromycin-Induced Visual Hallucinations
Published in Neuro-Ophthalmology, 2022
Daragh McGee, Cathal Hanley, Audrey Reynolds, Shane Smyth
Well-formed, dreamlike, colourful hallucinations that are more prominent in the dark can occur with brainstem or thalamic lesions (peduncular hallucinosis). Although the lack of acute findings on MRI argues against this diagnosis, the pontine microbleed is notable in this context. A review of five cases of peduncular hallucinosis found abnormal sleep behaviour in all cases. It noted the similar vivid, realistic, and affective quality of hallucinations that occur in Parkinson’s disease with rapid eye movement sleep abnormalities, narcolepsy-cataplexy-complex, Lewy-body dementia, and in the hypnagogic state.6 A proposed mechanism for clarithromycin-induced hallucinations, discussed below, is disruption to the reticular activating system. Young et al. proposed that neurotoxic insults can be seen as a ‘stress test’ of this system4 and clarithromycin could be seen as a functional insult to our patient’s brain, primed by an historic microbleed and/or chronic microvascular ischaemic changes. Her vision had been good since prior cataract surgery and, in the context of an unremarkable ophthalmological assessment, it is unlikely that these were visual release hallucinations (Charles Bonnet syndrome). The onset of symptoms shortly after starting clarithromycin and resolution quickly after discontinuation make a toxic effect of the latter more likely.
Phenomenology and Course of Alcoholic Hallucinosis
Published in Journal of Dual Diagnosis, 2019
Venkata Lakshmi Narasimha, Rahul Patley, Lekhansh Shukla, Vivek Benegal, Arun Kandasamy
First, two-thirds of the patients had past episodes of alcoholic hallucinosis which highlights the recurrent nature of this illness. Although it is possible that this is an inflated estimate due to the nature of our sample, this is in agreement with an earlier study from India showing a significant risk of recurrence (Perme, Vijaysagar, & Chandrasekharan, 2003). Therefore, it is prudent to expect hallucinations in a patient who has had them in the past and thus such cases may not be suitable for community detoxification.
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2019
David Bellows, Noel Chan, John Chen, Hui-Chen Cheng, Rauan Kaiyrzhanov, Peter MacIntosh, Michael Vaphiades
This literature search reviewed patients with peduncular hallucinosis, a rare syndrome of vivid, dream-like visual hallucinations that intrude on normal wakefulness. Additional clinical deficits, especially ophthalmoparesis, have historically been an important part of the diagnosis and localization of this syndrome. The authors examined how modern neuroimaging has impacted this diagnosis.