Bouritius Elyse M, Neven Arjen, Blom Jan Dirk
Parnassia Groep, afd. Palier, Den Haag.
Ned Tijdschr Geneeskd. 2015;159:A7901.
Alcohol hallucinosis is a rare complication of chronic alcohol abuse characterized by the acute onset of hallucinations during or after an episode of alcohol use. The hallucinations may persist for a long time, due to which the clinical picture can be mistaken for a disorder on the schizophrenia spectrum. The prognosis tends to be favourable, although untreated cases are associated with a considerable mortality risk (37% in eight years).
A 38-year-old male was admitted to a psychiatric hospital with hallucinations of acute onset during alcohol abuse which persisted for two months of abstinence. The patient experienced visual, auditory and tactile hallucinations during which time his consciousness, attention, orientation and higher cognitive functions remained intact. Somatic and neuroimaging investigations showed no abnormalities. The patient partially recovered on treatment with haloperidol.
If hallucinations are experienced during or after a period of alcohol abuse, the diagnosis of alcohol hallucinosis should be considered. The diagnosis must be distinguished from delirium tremens and schizophrenia spectrum disorder as treatment and prognosis are essentially different.
酒精性幻觉症是慢性酒精滥用的一种罕见并发症,其特征是在饮酒期间或之后急性出现幻觉。幻觉可能会持续很长时间,因此临床表现可能会被误诊为精神分裂症谱系障碍。尽管未经治疗的病例有相当高的死亡风险(八年内为37%),但其预后往往良好。
一名38岁男性因在酒精滥用期间急性出现幻觉且在戒酒两个月后仍持续存在而入住精神病院。患者出现视觉、听觉和触觉幻觉,在此期间其意识、注意力、定向力和高级认知功能保持完好。躯体检查和神经影像学检查均未发现异常。患者使用氟哌啶醇治疗后部分康复。
如果在酒精滥用期间或之后出现幻觉,应考虑酒精性幻觉症的诊断。由于治疗方法和预后本质上不同,该诊断必须与震颤谵妄和精神分裂症谱系障碍相鉴别。