Autoscopic Hallucination in Alcohol Dependence Syndrome: A Rare or Missed Phenomenon?

Abstract

Autoscopic phenomenon, a psychic illusionary duplication of one's own self, has been the subject of interest in the literature and science for years. It has been reported in various diseases of the central nervous system but with an unknown mechanism. Hallucinations are a common presentation in alcohol dependence syndrome during delirium tremens and as induced disorder. However, autoscopic hallucination has been rarely reported in the cases of alcohol dependence. We present a case of a 40-year-old man who experienced autoscopic hallucination during the withdrawal state of alcohol. He was successfully treated with detoxification and an antipsychotic medication and was doing well. The case highlights the need for strong suspicion and exploration of the autoscopic hallucination and autoscopic phenomenon in general in cases of alcohol dependence syndrome.

An unusual Case of Autoscopic Hallucination: A Case Report and Review of Literature

“…As described in the introduction, autoscopic hallucination seems to follow a wide range of substance use as well as organic etiologies but neither of which can be positively ascribed to the index patient [6][7][8][9]. The special feature of the index case is the occurrence of the autoscopic hallucination in a schizophrenic patient.…”

“…This phenomenon has been reported in association with organic pathology like meningitis, seizures, space-occupying lesions, brain tumours, migraine, delirium, post-traumatic brain lesions etc [1,[3][4][5][6][7]. Two cases of autoscopic hallucinations are reported which were associated with alcohol and drug-induced respectively [8,9]. A case is reported in a young male who had schizophrenia with a history of substance use10.…”

Autoscopic Hallucinations in an African American Female Patient With Schizophrenia

“…Though it has been reported that patients with neurological and psychiatric diseases like epileptic seizures, near-death experiences, meningitis, space-occupying lesions, brain tumors, migraines, delirium, posttraumatic brain lesions, multiple sclerosis, anxiety, sleep disturbances, substance use, alcohol withdrawal, medication side effect, infectious diseases like typhus, and altered psychological states have experienced autoscopic phenomena, the patient denies any history of the aforementioned conditions [ 1 - 2 , 4 , 7 - 12 ]. Furthermore, several cortical areas have been implicated in autoscopy either in the capacity of damage or hypofunction: the temporoparietal junction, the vestibular system, right occipital cortex, nondominant gyrus angularis, and extrastriate cortex [ 3 - 4 , 12 ].…”

“…“Any man who believes he can see his own image appear in front of him when there is no mirror to reflect it is therefore subject to a visual hallucination of an autoscopic character,” postulated Lhermitte [ 2 ]. Autoscopic phenomena are dramatic visual own-body perceptions with experiences involving the replication of one’s own body in extrapersonal space generally when they are awake [ 1 - 7 ]. The patient maintains insight throughout the experience [ 1 ].…”

“…The etiology of autoscopic phenomena remains fodder for further research, however, numerous studies have reported their association with various conditions [ 1 , 3 - 4 , 6 - 9 ]. Autoscopic phenomena have been reported in numerous focal and generalized disorders of the central nervous system (CNS), during epileptic seizures, near-death experiences, meningitis, space-occupying lesions, brain tumors, migraine, delirium, posttraumatic brain lesions, multiple sclerosis, anxiety, sleep disturbances, either during or subsequent to substance use, alcohol withdrawal, medication side effect, infectious diseases like typhus, and altered psychological states [ 1 - 2 , 4 , 7 - 12 ]. Additionally, low glucose has been shown to induce autoscopic hallucinations in one case that was treated by correcting the glucose level [ 12 ].…”