Abstract
Hallucinations are not uncommon in the pediatric population, and they can occur in a variety of presentations influenced by medical and non-medical factors. This case report summarizes existing literature concerning visual-tactile phobic hallucinations (VTPH) and describes a case with a unique presentation: VTPH in a child with stimulant-managed attention-deficit/hyperactivity disorder (ADHD). Observations made in this case and in those like it are used to characterize VTPH as a distinct psychiatric phenomenon that is observed in children without metabolic, neurologic, or other medical involvement. When it is a primary psychiatric symptom, VTPH typically has an acute but benign course that benefits not from a medically intensive approach, but rather one that explores psychosocial influences and provides reassurance and support.
Highlights
Hallucinations are false sensory perceptions not associated with any identifiable external stimuli
The following case describes the differential diagnosis and management of a pediatric patient with acute-onset visual-tactile phobic hallucinations (VTPH) who had been taking extended-release dextroamphetamine for attention-deficit/hyperactivity disorder (ADHD), a unique presentation that has not been reported in the literature
It would make sense to exercise a sensitive, trauma-informed approach to minimize the level of stress in the hospital and to provide reassurance. This case adds to the growing list of evidence for VTPH being a distinct psychiatric phenomenon, and as such, medical providers should be able to recognize the signs and symptoms of VTPH
Summary
Hallucinations are false sensory perceptions not associated with any identifiable external stimuli. No abuse or trauma histories were reported by either the patient or parents He was seen by his pediatrician within the week prior to presenting to the hospital; collateral information from the pediatrician indicated he was in his normal state of health and his ADHD was well-managed. On the night of the episode, the patient awoke at three in the morning, began to describe visual and tactile hallucinations, seeing and feeling spiders in his room, on his body, and in his mouth He made comments such as “I feel like spiders are crawling on me” and “I feel like I am on fire.”. For the two days, he continued to report seeing spiders in his room at times, causing distress These episodes eventually lessened in frequency and severity, and he was once again consoled by his parents. Two months after restarting dextroamphetamine, the patient’s hallucinations had not recurred
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