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Sunday, October 8, 2017

Tactile hallucinations: Causes, diagnosis, and treatment

Sat 7 October 2017 By Jennifer Huizen

Tactile hallucinations involve an abnormal or false sensation of touch or perception of movement on the skin or inside the body.
Tactile hallucinations tend to be associated with mental conditions or the use of drugs or medications.
The sensation of touch or movement without a known cause differentiates tactile hallucinations from other hallucinations.

What are the symptoms

Usually, the condition causes unpleasant, uncomfortable, disturbing sensations. Some people may feel that bugs are crawling over their body or something is inside them trying to get out.
Some individuals experience the feeling that their organs are shifting or that something is turning in their stomach or skull.
In some cases, however, the condition may cause more harmless, even somewhat pleasant sensations.
People who have hallucinations caused by Parkinson's disease report sensations such as the feeling of flying or floating.

Primary causes

Medical conditions known to cause tactile hallucinations include:

Schizophrenia

In a 2010 survey of 480 people in the United States with diagnosed schizophrenia and schizoaffective disorders88.5 percent had experienced hallucinations.
Although auditory and visual hallucinations were the most common symptoms, tactile hallucinations occurred in 27 percent of respondents.
In a 2016 study, out of 200 surveyed persons with schizophrenia, more than 50 percent had experienced visual or tactile hallucinations.

Parkinson's disease

As many as 39.8 percent of people with Parkinson's disease experience some form of hallucination, including tactile hallucinations. Hallucinations associated with the condition tend to be non-threatening, however, and have even been described by some people as amusing.
Some individuals will experience the sensation of animals or people around or near them or feel as though they are floating. Many people with Parkinson's disease have some understanding that the sensation is not real as it is happening.

Alzheimer's disease

As many as 53 percent of people with Alzheimer's disease experience visual, auditory, olfactory, or tactile hallucinations. Hallucinations tend to occur in moderate to severe cases, but not in the end stages of the condition. 

Lewy body dementia

As many as 65 percent of those with Lewy body dementia experience some form of hallucination, including tactile hallucinations.

Phantom limb syndrome

When some people lose a limb or the use of it, they continue to feel as though the limb is still attached or is very painful.

Delirium tremens

Severe alcohol withdrawal can cause delirium tremens, or rapid-onset, extreme confusion. Approximately 50 percent of long-term, heavy alcohol users experience symptoms of alcohol withdrawal when they cut back or stop drinking. And 3 to 5 percent of those people develop delirium, grand mal convulsions, or both.

Narcolepsy or falling asleep too quickly

The neurological condition narcolepsy has been known to cause extremely vivid or realistic hypnagogic hallucinations, a type of tactile hallucination that occurs just before fully falling sleep and fully being awake.
This form of hallucination is triggered when the body moves through the stages of falling asleep or waking up too quickly or skips steps. Nearly everyone will experience hypnagogic hallucinations, often as a sensation of falling, looking down from a great height, being unable to move or being touched.

Substances and medications

Substances and medications that can cause tactile hallucinations include:
  • anti-Parkinsonian agents
  • antidepressants
  • prescription stimulants
  • antihypertensive (propranolol)
  • anti-epileptics
Tactile hallucinations that involve the sensation of insects crawling on, biting, or stinging the skin tend to occur in people that have used potent stimulants, such as cocaine, narcotics, and amphetamines.
Alcohol intoxication can cause several forms of hallucination. In some rare cases, tactile hallucinations may occur.

How are tactile hallucinations diagnosed

A complete medical evaluation may be required for diagnosis.


Hallucinations can be difficult to diagnose.
The testing for many mental illnesses such as schizophrenia is predominately subjective, rather than based on concrete scientific evidence.
The diagnosis of any type of hallucination requires a complete medical, neurological, and psychiatric evaluation. Medical tests may include:
  • blood tests
  • urine tests
  • magnetic resonance imaging (MRI) scan of the brain.
In cases where the condition is related to substance use or known neurological conditions, a medical doctor or neurologist may consider tactile hallucinations as a diagnosis.
As a rule, tactile hallucinations differ from other types of hallucination because of the sensation of touch or movement without a known cause.

Treatment

In most cases the hallucinations stop with the use of neurological or antipsychotic medications, or when individuals safely detox from stimulant or depressant drugs.
Some at-home tips and types of counseling therapy may also reduce the impact of symptoms.

Atypical antipsychotics

Antipsychotic medications work by blocking neurotransmitters, such as dopamine, and slowing down or inhibiting nerve signaling and brain activity.
Atypical antipsychotics used to treat hallucinations, and other psychotic symptoms include:
  • risperidone
  • aripiprazole
  • olanzapine
  • ziprasidone
  • quetiapine
  • pimavanserin
  • clozapine

Adjusting medicine doses or switching medications

Several medications, especially those for the management of Parkinson's disease, carry a risk of hallucination. Lowering the dosage or stopping the use of these medications may be necessary to prevent hallucinations.

Withdrawal or depressant medications

If caused by delirium tremens, alcoholic hallucinations, or drug use, withdrawal medications are often used to help the body safely rid itself of the triggering substance. Benzodiazepines are commonly used to treat delirium tremens. 

Transcranial magnetic stimulation (TMS)

Slow, repetitive bursts of TMS may reduce brain excitability in people with schizophrenia who experience hallucinations, including auditory hallucinations.

Coping strategies

Coping strategies, such as engaging with hobbies and being physically active, may help to minimise the frequency of hallucinations.


Some people can minimise the frequency of hallucinations and the severity of their symptoms by using coping strategies.
Individuals who experience hallucinations as a result of neurological conditions tend to benefit from commonly used tricks, such as:
  • recognizing triggers and avoiding them
  • engaging with hobbies, listening to music, or watching television
  • being physically active
  • lying down or going to sleep
  • seeking out the company of friends and loved ones
  • meditation and relaxation techniques
  • talking out loud or in the mind
  • telling oneself the hallucination will eventually go away and is not real
  • going somewhere quiet or peaceful

Cognitive behavior therapy (CBT)

CBT focuses on reducing the risk of social disability and relapse by helping people understand their psychosis, become active in their treatment, and engage with society. It also usually involves the development of individualized coping strategies.

Psychoeducation

One of the largest problems with trying to treat hallucinations is that many people are reluctant to admit they have them.
Reading educational materials on hallucinations and mental illness, in general, can help people understand their symptoms and identify potential treatment options.
It is also often helpful for family members, partners, friends, or roommates to educate themselves so they can offer more understanding, supportive care.
https://www.medicalnewstoday.com/articles/319635.php

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