Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2004 Jan;60(1):25-7.
doi: 10.1016/S0377-1237(04)80152-7. Epub 2011 Jul 21.

Delirium Tremens

S R Mehta  1 , Hra Prabhu  2 , A J Swamy  3 , Harinder Dhaliwal  4 , Dinesh Prasad  5
Affiliations

Delirium Tremens

S R Mehta et al. Med J Armed Forces India. 2004 Jan.

Abstract

The varied clinical manifestations and management of 14 male patients with delirium tremens (DT) have been studied. Eight patients were initially hospitalised for diseases unrelated to ethanol abuse i.e. 2 each for gun shot wound, myocardial infarction and stroke, and one each for pneumonia and gastroenteritis. One patient was going through withdrawal because of prodrome of viral hepatitis before he was hospitalised for uncontrolled agitation and delirium. Two known cases of mild essential hypertension on dietary therapy reported for agitation, abnormal behaviour, a single episode of tonic clonic seizure and hypertensive encephalopathy as they could not/did not get alcohol for 3 days. Three patients presented denovo with DT without concomitant illness. The other features besides delirium and hallucinations were tremulousness in 10, tachycardia in 12, fever in 3, diaphoresis in 2 and tonic clonic seizures in 4 patients. The symptoms fluctuated markedly at short intervals and 2 patients did not have any features of sympathetic overactivity. Altered hepatic biochemical parameters and ketonuria with normal blood sugar were noted in 4 and one patients respectively. Other biochemical parameters including serum electrolytes were normal. CT scan brain done for 5 patients revealed subdural haematoma in one. Cerebro spinal fluid (CSF) and EEG findings were noncontributory. All made good recovery with heavy doses of intravenous vitamin B complex, glucose and oral benzodiazepine. Short course of haloperidol was used in 2 patients. Two patients developed pancreatitis during follow up. All patients made complete recovery, and 8 patients have been followed for 8 to 12 months without relapse. The reason for hospitalisation in such cases is often unrelated to alcohol abuse; hence a detailed history of alcoholism is mandatory to identify those at risk as well as for prompt treatment and decreasing the mortality.

Keywords: Alcohol withdrawal; Concomitant illnesses; Delirium; Precipitating events.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Signs, symptoms and investigations - delirium tremens
See this image and copyright information in PMC

References

    1. Rosenbloom A. Emerging treatment options in alcohol withdrawal syndrome. J Clin Psychiatry. 1998;49(suppl 12):28–31. - PubMed
    1. Johns AR. Management of withdrawal syndromes. In: Weaterall Ledingham, Warrel, editors. Oxford Textbook of Medicine. 3rd ed. Oxford University Press; New York: 1996. pp. 4290–4294.
    1. Wax PM. Withdrawal syndromes. In: Irwin, Rippes, editors. Intensive Care Medicine. 4th ed. Lippincott-Raven Publishers; New York: 1999. pp. 1806–1815.
    1. Victor M, Adams RD. The effects of alcohol on the nervous system. Proc Assoc Res Nerv Ment Dis. 1953;32:526–529. - PubMed
    1. Brown CG. The alcohol withdrawal syndrome. Ann Emerg Med. 1982;276:20–24. - PubMed

LinkOut - more resources