Abstract Presentations at the 2005 Wilderness Medical Society Meeting, Snowmass,
Colorado, July 23 to 27, 2005
Poster Presentation
Hallucinations in Adventure Race Athletes
David Townes, MD, MPH, FACEP
1
, Leonard Frank, MD
1
, Suzanne Bigleow, MD
1
, Kyle
McLaughlin, MD
2
, Leslie Iverson, ARNP
3
1
Division of Emergency Medicine, University of Washington School of Medicine,
Seattle, Washington
2
Department of Family Medicine, University of Calgary, Calgary, Canada
3
Department of Emergency Medicine, Oregon Health Sciences University, Portland,
Oregon
Introduction: Adventure races or wilderness multi-sport endurance events continue to
grow in popularity with increasing numbers of events and participants each year. The
provision of medical support for these events is both challenging and exciting. Athletes
are treated for a wide variety of both injury and illness during these events including
altered mental status. The differential diagnosis for altered mental status includes heat
stroke, dehydration, altitude illness, infection, toxic ingestion, head injury, hyponatremia,
mental illness, and sleep deprivation. Depending on the situation, it may be difficult to
determine the exact etiology.
Objective: Previously, athletes have reported hallucinations to medical personnel during
adventure races however the incidence is unknown. The objective of this study is to
determine the incidence of hallucinations in these athletes. This information will assist
medical providers in their evaluation of athletes presenting with altered mental status.
Methods: The 2004 Subaru Primal Quest Expedition Length Adventure Race was held in
the Northern Cascade Mountains of Washington State. During pre-race registration,
athletes were asked to complete a questionnaire about hallucinations during previous
adventure races. The results were used to determine the incidence of hallucinations
during adventure races.
Results: Of the 250 athletes eligible to participate in the study, 240 agreed to participate
and were enrolled. Of those athletes completing the questionnaire, greater than 75%
reported hallucinations during previous adventure races. The majority of these were
visual in nature.
Conclusion: Athletes participating in expedition length adventure races are treated for a
wide variety of injury and illness. When an athlete presents with altered mental status, it
is often difficult to determine the etiology of their symptoms. This study demonstrates the
high incidence of hallucinations during these events highlighting a potential and
previously under recognized cause of altered mental status in these athletes.
