Pseudo Hallucinations - Radio Reception Through Shrapnel Fragments

Am

J Psychiatry

138:9,

September

1981

LETTERS

exhibited hyperactivity, flight of ideas, rapid speech, osity, and an angry affect. She had a history ofheavy consumption, but her general physical health was When Ms. A was admitted, she reported that she been drinking or taking any prescribed medication. hospital day I at 10:00 a.m. Ms. A was given 5 mg halopenidol to treat her loudness, hyperactivity, and ity. She was not placed 3:00 p.m. the same day

on regular she began

dosages to hold

grandialcohol good. had not On i.m.

of

hostil-

of haloperidol. her throat and

that she could not breathe or swallow. She indicated that the haloperidol was causing this reaction and whispered that she needed benztropine mesylate immediately. The nurse quickly administered

mm Ms. prescribed weekend. days.

benztropine

mesylate,

2 mg

i.m.

After

A’s dyspnea and anxiety disappeared. I mg of oral benztropine mesylate b.i.d. Ms. A had no further episodes during

I asked

Ms.

causing

her

A why

she

distress.

had

She

thought

said

the

she

had

30

I then for the those 2

haloperidol

had

was

two

similar

episodes when she was hospitalized in another state. On both occasions she experienced problems breathing and swallowing while receiving only halopenidol. Her problems

were relieved by intramuscular doses of benztropine mesylate. At other times Ms. A had received tnifluoperazine and thiothixene. but each time she had received either of these drugs drugs.

she

was

started

concomitantly

on

antiparkinsonism

A laryngeal-pharyngeal dystonia is a frightening experience for patients and physicians. I agree with Dr. Menuck that this is a high-risk, potentially lethal complication. One preventive measure would be to take a careful drug history from the patient regarding previous reactions to medications before starting drug regimens. especially low dosages of high-potency neuroleptics like haloperidol. CLARENCE

Hypersexuality

in Men

E.

Receiving

MCDANAL. Birmingham

Fluphenazine

JR.

.

,

medication,

Mr.

A Ia.

edition,

lists

women

anticholinergic

cause The

impotence

as endocrine

symptoms

or

them

to discontinue Physician’s Desk in

men

side effects

and

his

who

complained

as

impaired

an otherwise Reference. 1980

increased

libido

offluphenazine

about

the

sister

had

found

one of her daughters. plaints activities

Mr.

Mr.

and admitted to as often as three

1. Mr. A was a 25-year-old

of schizophrenic times azines,

switched every

and

disorder.

unsuccessfully

butyrophenones,

to long-acting 3 weeks.

was decreased was physically

man

He had treated and

thioxanthenes

that

himself

wet dreams times a day.

his and He

against

sister’s

com-

to masturbatory was not receiving

prolactin,

and

testosterone.

except

for the prolactin

serum

levels.

We

The

(16.5

results

ng/ml)

discontinued

were

and

LH

all

negative

(62.5

fluphenazine

and toxLH,

mIU/ml)

because

Mr.

had been in remission for about 2 years. Four weeks Mr. A became disorganized, delusional, and belligerent had to be hospitalized. Case

2. Mr. B was a 28-year-old

the father of three chronic schizophrenia,

children. with

man

who

A

later and

was married

and

He had a 4-year history three previous hospitalizations.

of

He had been in satisfactory remission for about I year after receiving fluphenazine decanoate 12.5 mg i.m. every 3 weeks.

Mr.

B was

in good

physical

health

and

was

not

taking

any other medication. He worked as a janitor and had no complaints about himself or his work. The only complaint came from his wife, who had noticed that for the first time in their marriage Mr. B was demanding sex every day. She also discovered that when she refused him, he would go to pornographic movies and engage in sexual activities with prostitutes. The results of physical and neurological examinations were within normal limits. Laboratory work-up included EEGs, chest X rays, CBC. toxic screen. thyroid studies, VDRL, serum levels ofprolactin. testosterone, LH,

were within normal limits except for ng/ml) and LH (40.5 mIU/ml). Mr. B compound, after of his hypersexuality.

which

found more

ofthe about in

literature

reveals

only one research on the influences

residual functions.

a paucity

of methodolog-

the role of endocrine and nonendocnine neuroleptic-induced sexual dysfunctions: I paper (1) that qualifies as such. We also need

symptomatology

in the

of psychotic

disorder

production

of

or its

sexual

dys-

in

decanoate.

REFERENCE

1. Erdos

MA, Polgar

M: Endocrinological

sexual dysfunction under makopsychiatr 12:426-431,

changes

long-term 1979

neuroleptic

in patients treatment.

with Phar-

hypersexuality.

with

been with

to report

A rubbing

A confirmed

EFRAIN

Case

clinic

any other medication. We gave Mr. A complete physical neurological examinations . Laboratory studies included ic drug screen, VDRL, and serum levels of FSH,

ic studies mechanisms

The following cases, however, describe two schizophrenic men who received long-acting fluphenazine and developed hypersexuality rather than impotence. It should be noted that it was close family members and not the patients themselves

to the

‘

A review

and

came

boy and two girls, 12 the reduction of the

Decanoate

A large number of ambulatory chronic schizophrenic patients are treated with periodic injections of fluphenazine decanoate. Many do well until adverse side effects. such sexual reactions, successful therapy.

sister

was switched to a dihydroindolone he showed a moderate decrease

SIR:

extrapyramidal

A’s

1263

EDITOR

although Mr. A was much improved, he was ‘horny’ ‘ all the time, a condition that was unusual for him. He masturbated and frequently propositioned neighborhood girls. On one

and FSH. All the results elevated prolactin (16.7

M.D.

THE

illegitimate children were a 14-year-old and 13 years of age. Six weeks after

occasion

At gasp

TO

a 6-year

hospitalized alliphatic

A.

history

M.D. Tex.

GOMEz,

Houston,

four

phenothiuntil

he

was

fluphenazine decanoate, 25 mg i.m. When Mr. A improved noticeably the dosage to 12.5 mg. Mr. A lived with his mother, who disabled, and a 30-year-old sister, whose

Pseudohallucinations: Fragments SIR:

was

We recently

initially

thought

Radio

treated

Reception

a patient

to be musical

Through

who suffered hallucinations

Shrapnel

from what but

actually

1264

LETTERS

appeared fragments

TO

THE

EDITOR

Am J Psychiatry

to be reception of radio implanted in his skull.

signals

through

shrapnel

organic 1894 3.

Mr.

A,

recurrent

a 35-year-old

veteran.

depression

sustained combat.

and

had

a 9-year

headaches.

shrapnel wounds in his skull When Mr. A was admitted

complained

of

having

history

Twelve

headaches

years

of

ago

disease

Ross ED. deafness.

ofthe

Jossman JAMA

4. Anonymous:

he

JAMA

sensory

organs,

PB, Bell 231:620-621,

Radio

169:1271,

138:9,

B,

etc.

et at: 1975

transmission

dysphoria

and

supine on We found

the no

Physical examination healed scars in Mr.

concrete signs or

was

floor of symptoms

unremarkable

his of

for

CT scan and small metallic

150

mg

h.s.

on the

band

regardless

of the

time

of day

April

cope

with

this

We informed signals through by this finding

Fools’

or type

accompany

major

organic

dementias.

scnibed

less

functional but

spoken

psychoses,

Musical

often,

as

words.

toxic

hallucinations

often

delirium, have

have been associated (I) and sensorineural

and

been

de-

with vascular deficits (2. 3).

and tumoral lesions There have been few reports in the literature concerning radio reception through dental work (4). We propose that a mechanism for Mr. A’s reception of radio broadcasts involves the metal implants’ provision ofdiode rectification of

the signal. Thus plished by these way

as

a crystal

transmitted

The

by

as was

the examiner The report

radio bone

perception

clear,

detection and metals implanted

demodulation are accomin bone (much the same operates). The audio is then

set

conduction

to the

of the received the

case

with

signals

Mr.

A, who

the specific content of this phenomenon

diagnosis of patients who tions” but exhibit no other

suffer signs

auditory

may could

not

from auditory of psychosis.

Suddenly

Lady

me

shoulder.

I could

her

cold

convey

else all the time. Sometimes sometimes .5, sometimes or .6. When she became

REFERENCES

H: Epilepsy and the Functional Boston, Little, Brown and Co.

Anatomy of 1954. pp 452-

467 2. Coleman

WS:

Hallucinations

in the

sane

associated

with

F/a.

local

all

her

by M. I

she was:

fireworks

of phe-

humble

Deese

she

M. III balked

not

get

close

and showed

to her:

cool

she

so unhelpful! Her detailed, me to feel the same way. In she called herself something her depression remitted and

was digited as .3, called that .3 or .5

very crazy she called it either .2 or .4. Only when she was dull and unspecified was she consistently zero. By that time I lay prostrate-totally fragmented and hopelessly frustrated! When I thought I knew her she away

again.

there

Who

not

have

spurious,

Deese

edgy,

admired her at first. truly to be loved

meaningful behaved

along

III’s

I thought

she

the

probably

porcupine

bureaucratic

fireworks

or

would

were

rather

pleasing.

How

be a fantastic

index:

I

object

could have personalities

when

I wanted

a her

from me, and when I wanted to she suffocated and drained

force

I never got her number In the past I usually would

born

dollars-wasted

cherished, and we But like all borderline

she slipped away far away-because

sinister

logical

harmonious

relationship.

to be close push her

of my nine

not and

of hers,

to foes or friends alike. It is so that I can hide it and do

daily

M.

and

me?

monster

not useful goodness.

to be reminded

adoption fees! I found out

she

mirrors

is that little

as an afterthought, small enough, thank

to

‘ ‘ hallucina-

M. III. and there

with

was and nearly frigid. and fragmented obsessions caused the shifting states of passion

pushed

right! hurt from

her right

back

complicated

upon

relation-

ships like this and suffer in silence, telling myself I am not smart and bright enough to comprehend sophisticated ladies like Deese M. III. After a successful analysis. however, I do not feel that way any more. Those feelings were caused by a dysthymic I am now

1. Penfield W, Jasper the Human Brain.

M.D.

B. LIGGETT

‘ ‘ I got phenomenal dillydallying. I with Lady Deese M. III and get out. I wanted to truly. affectively her fanfare facade of a theoreti-

atheoretical, real affair the inside get under

cal folderol.

me.

of news broadcasts. may aid the differential

me

‘

me-a

apparatus.

not be perfectly

Deese

blitzing

sick of all this wanted to have a to know her from own her, use her,

of

him that we felt that he his shrapnel implants. and felt that he could

to meeting

detailed,

slipped such

BOZA,

nomena. She is a name dropper, but she is also very and demurely says, ‘I don’t know why. Eventually

and

,

forward

logical,

problem.

hallucinations,

A.

Correspondence

And then Auditory

to ed).

SIR: I have been trying very hard to get to like DSM-IJJ using it. Believe me, I have been trying, but Lady Deese III is cold to my overtures! Cognitively/theoretically

looked

programming. When only the examiner listened to this station with an earphone, Mr. A was able to hum the music he was hearing. correctly identify pauses and changes in the programming. and could precisely tap out the beat of the songs being broadcast. was receiving radio He felt quite relieved

(ltr

well-

headaches improved. but the auditory phenomena continued. Mr. A stated that he heard the music mainly with his left ear and that it had a definite radio-like quality. One of us (S.L.) tested him by asking him to match his perceptions with various stations on the AM broadcast band. He consistently identified the same station (560 kHz) while the radio was tuned to various stations

fillings

in

Miami,

EEG were normal. Plain skull films revealed densities in the soft tissues and cranial bones

of the left parieto-occipital region. We treated Mr. A with amitriptyline, thiothixene, 10 mg/day. His mood and

hallucinations

STEPHEN

A’s neck and left shoulder. We discovor hearing impairment. Neuropsychological mildly impaired long-term memory. Mr. A’s

ered no tinnitus testing showed

Musical

RAMON

of

metal-walled psychosis.

except

Br Med J 1:1015-1017,

through

hearing voices and music. The auditory phenomena were characterized by a perception of radio-like music and voices that often changed in rhythm. These ceased only when Mr. A was garage.

198!

1959

and shoulder during to our service, he

and

September

creators. Why slightly making ‘

(neurotic) addressing

do I think

that

brainwashed me believe

‘over-reacting.

conflict, my

Deese by that

irrational,

now well grievances

M. III

Deese M. everything

egocentric,

resolved. to Deese

is female?

Have

III’s parents capricious,

vain

Therefore M. III’s

and

I been who are illogical,

demanding