Visual hallucinations in a toddler: Accidental ingestion of a sympathomimetic over-the-counter nasal decongestant

Hallucinations are uncommonly encountered in the young child. The differential diagnosis of such behavior includes a number of potentially serious syndromes such as central nervous system malignancy, encephalitis, temporal lobe epilepsy, closed head trauma with frontal lobe contusion, hypoglycemia, drug intoxications, and childhood psychiatric syndromes. Organic explanations are most often discovered and frequently involve toxicologic causes. A case is presented of a toddler with hallucinations caused by inappropriately high doses of pseudoephedrine.