In this episode, second-year medical students Michelle Buncke and Jennifer DiPietro discuss the pathophysiology of visual hallucinations that occur during extreme endurance events and the differential diagnosis for an athlete that presents to the Emergency Department complaining of hallucinations.

• Courtney Dauwalter Ultrarunning Interview: https://www.redbull.com/gb-en/courtney-dauwalter-ultrarunning-interview

References: 

1. Carbone MG, Pagni G, Maiello M, Tagliarini C, Pratali L, Pacciardi B, Maremmani I. Misperceptions and hallucinatory experiences in ultra-trailer, high-altitude runners. Riv Psichiatr. 2020 May-Jun;55(3):183-190. doi: 10.1708/3382.33575. PMID: 32489196.
2. Kahn-Greene, E. T., et al. (2007). “The effects of sleep deprivation on symptoms of psychopathology in healthy adults.” Sleep Medicine 8(3): 215-221.
3. Moshirfar M, Ding Y, Ronquillo Y, Birdsong OC, Murri MS. Ultramarathon-Induced Bilateral Corneal Edema: A Case Report and a Review of the Literature. Ophthalmol Ther. 2018;7(1):197-202. doi:10.1007/s40123-018-0125-y
4. Reeve, S., et al. (2015). “The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review.” Clinical Psychology Review 42: 96-115.
5. Schaider, Jeffrey J., et al., editors. “Hallucinations.” 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307655/all/Hallucinations.
6. Waters, F., et al. (2018). “Severe Sleep Deprivation Causes Hallucinations and a Gradual Progression Toward Psychosis With Increasing Time Awake.” Frontiers in Psychiatry 9.
7. Waters F, Dragovic M. Hallucinations as a presenting complaint in emergency departments: Prevalence, diagnosis, and costs. Psychiatry Res. 2018 Mar;261:220-224. doi: 10.1016/j.psychres.2017.12.074. Epub 2018 Jan 2. PMID: 29329038.

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