Lilliputian Hallucinations and Marijuana Dependence in a Bipolar Patient

Abstract

In 400 A.D. Sa int Macarius, th e Egypti an , expe rienced and described a bizarre perceptual ph en om en on (2) . Aft er a period of fas t ing, he visua lized "l itt le strangers" whi ch he beli eved were "dae mo ns like flies se tt ling on his mouth (2)." In 1726, J on athan Swift coine d th e term "lilliput ia n" in his sa t ir ica l boo k, Gulliver's Travels. He described th e inhabit ant s of th e land of Lilli pu t by wri ting, "I fe lt something aliv e movin g on my Leg, whi ch adva ncing ge n t ly forward ove r my Breast, ca me almost up to my C hin; whe n bending m ine Eyes downwa rd s as mu ch as I could , I perceived it to be a human C rea ture not six Inch es high , with a Bow an d Arrow in his Ha nds, a nd a Quiver a t his back (3) ." In 1909, Leroy ut ilize d th e term "li lliput ian" in th e descript ion of a spec ific type of perceptual ab norma lity (4) . Visu al hallucin ation s in which peopl e, a nimals, or objects appear red uced in size a re referred to as lilliputian hallucin ation s. H allucin ation s of th is type have been associa te d with variou s psychi atric cond it ions (4,5, 12, 14,15, 16), se nile dement ia (16), neurologic di sorders (810,17), toxi c met abolic sta tes (6,7), head trau ma ( 13), AIDS ( 13), and ophthalmologic di sorders ( I I). This ph en om en on ca n be pleasu rable (4) or terrifyin g (2) depending on th e con te nt of th e hallucination a nd the contex t in whi ch it is expe rience d.