Auditory Hallucinations

Question 1

Define auditory hallucinations

Answer 1

False perceptions of sounds e.g. internal voices or noises despite a lack of external stimulus

Question 2

What are the causes of auditory hallucinations

Answer 2

Schizophrenia
Bipolar affective disorder
Borderline personality disorder
Parkinson’s disease
Alzheimer’s disease
Recreational drug us: MDMA, LSD
Auditory cortex epilepsy
Sleep (normal): When falling asleep (hypnagogic) or when waking up (hypnopompic)
Hepatic encephalopathy

Question 3

What questions should be asked to assess auditory hallucinations

Answer 3

“can you see or hear things that other people can’t”
“Have you heard people talking about you when you thought you were alone”

When the hallucinations started
When they tend to occur - how frequently, is there a trigger or specific time
Content:
- What are they hearing
- Who is speaking (the patient, an acquaintance, a random voice)
- Are they speaking directly to the patient
- What do they say
— Someone talking to you
— Someone talking about you
— Running commentary - describing everything you do as you do it
— Thought echo - do they say your thoughts out loud
- Whether they get any commands
— What do they tell you to do
— Can you resist
- OR what sound do they hear
- Insight into what they are hearing

Question 4

What investigations should be done for auditory hallucinations

Answer 4

MSE
Bedside: urine toxicology
Bloods: FBC, vit B12/folate, U&Es, LFTs, blood alcohol
Other: MRI, CT, EEG