Delirium tremens history and symptoms: Difference between revisions
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{{Delirium tremens}} | {{Delirium tremens}} | ||
{{CMG}} {{AE}} {{ | {{CMG}} {{AE}} {{ZMalik}} | ||
== History and Symptoms == | ==Overview== | ||
===Symptoms=== | The hallmark of delirium tremens is [[tremor]], [[confusion]], [[disorientation]], [[agitation]], signs of severe [[Autonomic nervous system|autonomic]] instability ([[fever]], [[tachycardia]], [[hypertension]]) with a positive history of [[alcohol]] cessation 48 - 72hrs prior in a patients with history of [[chronic]] [[alcohol]] abuse. | ||
==History and Symptoms== | |||
*The hallmark of delirium tremens is [[tremor]], [[confusion]], [[disorientation]], [[agitation]], signs of severe [[Autonomic nervous system|autonomic]] instability ([[fever]], [[tachycardia]], [[hypertension]]) with a positive history of [[alcohol]] cessation 48 - 72hrs prior in a patients with history of [[chronic]] [[alcohol]] abuse. | |||
===History=== | |||
Patients with delirium tremens may have a positive history of: | |||
* [[Chronic]] heavy use of [[alcohol]] | |||
* No [[alcohol]] consumption in last 48-72 hours in a heavy drinker | |||
* Previous [[alcohol withdrawal]] | |||
* [[Substance abuse]] (e.g. [[benzodiazepines]]) | |||
===Common Symptoms=== | |||
Common symptoms of delirium tremens include: | |||
* [[Tremor]] | |||
* [[Hallucination]]s | |||
* [[Agitation]] | |||
* [[Confusion]] | * [[Confusion]] | ||
* [[Disorientation]] | * [[Disorientation]] | ||
===Less Common Symptoms=== | |||
Less common symptoms of delirium tremens include | |||
* [[Anxiety]] | * [[Anxiety]] | ||
* [[Panic attacks]] | * [[Panic attacks]] | ||
* [[Paranoia]] | * [[Paranoia]] | ||
Other common symptoms include intense [[hallucination]]s such as visions of insects, snakes or rats (or stereotypically, [[Seeing pink elephants|pink elephants]] or [[Glossary_of_psychiatry#Lilliputian_hallucinations|tiny figures]]). These may be related to the environment, e.g., patterns on wallpaper that the patient would perceive as giant spiders attacking him or her. Unlike hallucinations associated with [[schizophrenia]], delirium tremens hallucinations are primarily visual, but associated with tactile hallucinations such as sensations of something crawling on the subject - a phenomenon known as [[formication]]. Delirium tremens can sometimes be associated with severe, uncontrollable [[tremor]]s of the extremities and secondary symptoms such as anxiety, panic attacks and [[paranoia]]. | |||
Delirium tremens (DT) should be distinguished from [[alcoholic hallucinosis]], the latter occurring in approximately 20% of hospitalized alcoholics and not carrying a significant mortality. In contrast, DT occurs in 5-10% of alcohol-dependent people and carries up to 5% mortality with treatment and up to 35% mortality without treatment.<ref>[http://www.emedicine.com/EMERG/topic123.htm eMedicine - Delirium Tremens : Article by William G Gossman<!-- Bot generated title -->]</ref> DT is characterized by the presence of altered [[sensorium]]; that is, a complete hallucination without any recognition of the real world. DT has extreme autonomic hyperactivity (high pulse, blood pressure, and rate of breathing), and 35-60% of patients have a fever. Some individuals experience [[seizure]]s. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Substance abuse]] | [[Category:Substance abuse]] | ||
[[Category:Alcohol abuse]] | |||
[[Category:Abuse]] | [[Category:Abuse]] | ||
[[Category:Psychiatry]] | [[Category:Psychiatry]] | ||
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[[Category:Intensive care medicine]] | [[Category:Intensive care medicine]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Needs content]] | |||
[[Category:Needs overview]] | |||
Latest revision as of 15:41, 8 August 2023
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Overview
The hallmark of delirium tremens is tremor, confusion, disorientation, agitation, signs of severe autonomic instability (fever, tachycardia, hypertension) with a positive history of alcohol cessation 48 - 72hrs prior in a patients with history of chronic alcohol abuse.
History and Symptoms
- The hallmark of delirium tremens is tremor, confusion, disorientation, agitation, signs of severe autonomic instability (fever, tachycardia, hypertension) with a positive history of alcohol cessation 48 - 72hrs prior in a patients with history of chronic alcohol abuse.
History
Patients with delirium tremens may have a positive history of:
- Chronic heavy use of alcohol
- No alcohol consumption in last 48-72 hours in a heavy drinker
- Previous alcohol withdrawal
- Substance abuse (e.g. benzodiazepines)
Common Symptoms
Common symptoms of delirium tremens include:
Less Common Symptoms
Less common symptoms of delirium tremens include
Other common symptoms include intense hallucinations such as visions of insects, snakes or rats (or stereotypically, pink elephants or tiny figures). These may be related to the environment, e.g., patterns on wallpaper that the patient would perceive as giant spiders attacking him or her. Unlike hallucinations associated with schizophrenia, delirium tremens hallucinations are primarily visual, but associated with tactile hallucinations such as sensations of something crawling on the subject - a phenomenon known as formication. Delirium tremens can sometimes be associated with severe, uncontrollable tremors of the extremities and secondary symptoms such as anxiety, panic attacks and paranoia.
Delirium tremens (DT) should be distinguished from alcoholic hallucinosis, the latter occurring in approximately 20% of hospitalized alcoholics and not carrying a significant mortality. In contrast, DT occurs in 5-10% of alcohol-dependent people and carries up to 5% mortality with treatment and up to 35% mortality without treatment.[1] DT is characterized by the presence of altered sensorium; that is, a complete hallucination without any recognition of the real world. DT has extreme autonomic hyperactivity (high pulse, blood pressure, and rate of breathing), and 35-60% of patients have a fever. Some individuals experience seizures.