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In what sensory modalities may hallucination occur and does the modality suggest a particular syndrome or etiology?
Hallucinations may be experienced in any sensory modality
- visual,
- olfactory,
- gustatory,
- tactile,
- somatic,
- proprioceptive,
- equilibroceptive,
- nociceptive,
- thermoceptive,
- chronoceptive
Hallucination Modalities and Associated Syndrome or Etiology
| Modality | Associated Syndrome/Etiology | Comment |
|---|---|---|
| Auditory | Schizophrenia and related psychotic disorders (SaRPD), mood disorders with psychotic features | Rare to have other types in the absence of auditory in SaRPD |
| Visual | Delirium, migraine, REM-intrusion (narcolepsy, sleep deprivation) Substance intoxication/withdrawal Dementia with Lewy bodies, epilepsy, Charles Bonnet syndrome, midbrain (peduncular) pathology | Hypnagogic and hypnopompic hallucinations are considered normal Insight is more likely retained |
| Olfactory and gustatory | Seizure disorder (temporal lobe epilepsy), schizophrenia, migraines, Parkinson’s disease | Typically unpleasant odors (e.g., feces) in schizophrenia |
| Tactile | Substance (e.g., stimulants), alcohol and benzodiazepine withdrawal, delusional parasitosis | Formication is the sensation of insects crawling on the skin |
| Somatic | Schizophrenia, limbic, and temporal lobe epilepsy, anti-Parkinson’s medications, multiple sclerosis, thalamic pain syndrome | Typically unpleasant (e.g., feeling organs rotting) in schizophrenia |
| Chronoceptive | Substance use (e.g., stimulants, psychedelics) |
Sources
Freudenreich O, Brown HE, Holt DJ. Psychosis and schizophrenia. In Stern TA, Fava M, Wilens TE, Rosenbaum JF, editors. Massachusetts General Hospital Comprehensive Clinical Psychiatry. London, Elsevier, p. 314 ( Box 28-3 ), 2016.
