Delirium tremens history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]
History and Symptoms
The main symptoms are confusion, disorientation and agitation and other signs of severe autonomic instability (fever, tachycardia, hypertension). 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.
The main symptoms are:
Other common symptoms include:
- Anxiety
- Intense hallucinations - formication
- Panic attacks
- Paranoia
- Tremors