What Are Hallucinations?

If you're like most folks, you probably think hallucinations have to do with seeing things that aren't really there. But there's a lot more to it than that. It could mean you touch or even smell something that doesn't exist.

There are many different causes. It could be a mental illness called schizophrenia or a nervous system problem like Parkinson's disease.

If you or a loved one has a hallucination, you need to see a doctor. You can get treatments that help control them, but a lot depends on what's behind the trouble.

How You Might Hallucinate

Hear voices. Your doctor may call this an "auditory hallucination." You may sense that the sounds are coming from inside or outside your mind. You might hear the voices talking to each other or feel like they're telling you to do something.

See things. This is also known as a "visual hallucination." For example, you might see insects crawling on your hand or on the face of someone you know.

Sometimes they look like flashes of light. A rare type of seizure called "occipital" may cause you to see brightly colored spots or shapes.

Smell things. The technical name for this is "olfactory hallucination." You may think the odor is coming from something around you, or that it's coming from your own body.

Taste things. These are called "gustatory hallucinations." You may feel that something you eat or drink has an odd taste.

Feel things. Doctors call this a "tactile hallucination." It might seem to you that you're being tickled even when no one else is around, or you may have a sense that insects are crawling on or under your skin. You might feel a blast of hot air on your face that isn't real.

What Causes Hallucinations?

Schizophrenia. More than 70% of people with this illness get visual hallucinations, and 60%-90% hear voices. But some may also smell and taste things that aren't there.

Parkinson's disease. Up to half of people who have this condition sometimes see things that aren't there.

Alzheimer's disease and other forms of dementia . They cause changes in the brain that can bring on hallucinations. It may be more likely to happen when your disease is more advanced.

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Migraines . About a third of people with this kind of headache also have an "aura," a type of visual hallucination. It can look like a multicolored crescent of light.

Brain tumor. Depending on where it is, it can cause different types of hallucinations. If it's in an area that has to do with vision, you may see things that aren't real. You might also see spots or shapes of light.

Tumors in some parts of the brain can cause hallucinations of smell and taste.

Charles Bonnet syndrome. This condition causes people with vision problems like macular degeneration, glaucoma, or cataracts to see things. At first, you may not realize it's a hallucination, but eventually, you figure out that what you're seeing isn't real.

Epilepsy. The seizures that go along with this disorder can make you more likely to have hallucinations. The type you get depends on which part of your brain the seizure affects.

What’s the Treatment?

First, your doctor needs to find out what's causing your hallucinations. He'll take your medical history and do a physical exam. He'll ask about your symptoms.

You may need tests to help identify the problem. For instance, an EEG, or electroencephalogram, checks for unusual patterns of electrical activity in your brain. It could show if your hallucinations are due to seizures.

You might get an MRI, or magnetic resonance imaging, which uses powerful magnets and radio waves to make pictures of structures inside your body. It can find out if a brain tumor or something else, like an area that's had a small stroke, could be causing your hallucinations.

Your doctor will treat the condition that's causing the hallucinations. The treatment can include things like:

Your doctor may prescribe pimavanserin (Nuplazid). This medicine has been effective in treating hallucinations and delusions linked to psychosis that affects some people with Parkinson’s disease.

Sessions with a therapist can also help. For example, cognitive behavioral therapy, which focuses on changes in thinking and behavior, helps some people manage their symptoms better.

WebMD Medical Reference Reviewed by Neil Lava, MD on June 25, 2016

Sources

SOURCES:

Teeple, R. The Primary Care Companion to the Journal of Clinical Psychiatry, 2009.

Ali, S. Current Psychiatry, November 2011.

National Institute of Mental Health: "Schizophrenia."

Alzheimer's Association: "Hallucinations and Alzheimer's."

Capampangan, D. Annals of Emergency Medicine, October 2010.

Kathirvel, N. Progress in Neurology and Psychiatry, January/February 2013.

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