Delirium tremens
| Delirium tremens | |
|---|---|
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| An alcoholic man with delirium tremens on his deathbed, surrounded by his terrified family. The text "L'Alcool Tue" means "Alcohol Kills" in French. | |
| Classification and external resources | |
| Specialty | Neurology |
| ICD-10 | F10.4 |
| ICD-9-CM | 291.0 |
| DiseasesDB | 3543 |
| MedlinePlus | 000766 |
| eMedicine | med/524 |
| MeSH | D000430 |
Delirium tremens (DTs) is a rapid onset of confusion usually caused by withdrawal from alcohol. When it occurs, it is often three days into the withdrawal symptoms and lasts for two to three days. People may also see or hear things other people do not. Physical effects may include shaking, shivering, irregular heart rate, and sweating. Occasionally, a very high body temperature or seizures may result in death. Alcohol is one of the most dangerous drugs to withdraw from.
Delirium tremens typically only occurs in people with a high intake of alcohol for more than a month. A similar syndrome may occur with benzodiazepine and barbiturate withdrawal. Withdrawal from stimulants such as cocaine does not have major medical complications. In a person with delirium tremens it is important to rule out other associated problems such as electrolyte abnormalities, pancreatitis, and alcoholic hepatitis.
Prevention is by treating withdrawal symptoms. If delirium tremens occurs, aggressive treatment improves outcomes. Treatment in a quiet intensive care unit with sufficient light is often recommended. Benzodiazepines are the medication of choice with diazepam, lorazepam, chlordiazepoxide, and oxazepam all commonly used. They should be given until a person is lightly sleeping. The antipsychotic haloperidol may also be used. The vitamin thiamine is recommended. Mortality without treatment is between 15% and 40%. Currently death occurs in about 1% to 4% of cases.
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Wikipedia