delirium tremens


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delirium

 [dĕ-lēr´e-um] (pl. deli´ria)
An acute, transient disturbance of consciousness accompanied by a change in cognition and having a fluctuating course. Characteristics include reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there may also be a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a number of conditions that result in derangement of cerebral metabolism, including systemic infection, cerebral tumor, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as fluid, electrolyte, or acid-base imbalance, hypoxia, hypoglycemia, or hepatic or renal failure.
alcohol withdrawal delirium (delirium tre´mens) an acute alcohol withdrawal syndrome that can occur in any person who has a history of drinking heavily and suddenly stops. It can occur with any form of alcoholic beverage, including beer and wine, and is most commonly seen in chronic alcoholics. The severity of the symptoms usually depends on the length of time the patient has had a problem of alcohol abuse and the amount of alcohol that had been drunk before the abstinence that precipitated the delirium. See also alcoholism.
Clinical Course. Generally, this syndrome begins a few days after drinking has ceased and ends within 1–5 days. It can be heralded by a variety of signs and symptoms. Some patients exhibit only mild tremulousness, irritability, difficulty in sleeping, an elevated pulse rate and hypertension, and increased temperature. Others have generalized convulsions as the first sign of difficulty. Most persons exhibit severe memory disturbance, agitation, anorexia, and hallucinations.

Hallucinations are likely to follow the early signs and usually, but not always, are unpleasant and threatening to the patient. These hallucinations can be of three types: auditory, visual, or tactile. Delusions often follow or accompany the hallucinations. These patients are unable to think clearly and sometimes become paranoid and greatly agitated. At this point they can become dangerous to themselves and others.

Generalized grand mal seizures can occur in delirium tremens. The hallucinations and delusions may continue, contributing to the state of agitation and precipitating seizures.
Treatment and Patient Care. Persons with delirium tremens are very ill and have multiple short-term and long-term problems. They should be kept in a quiet, nonstimulating environment and approached in a calm, reassuring manner. They must be watched closely and protected from self-injury during the period of delirium and also when they are convalescing from their illness and are likely to feel great remorse and depression. They should be observed for signs of extreme fatigue, pneumonia, or heart failure. Respiratory infections are quite common in these patients because of their weakened condition and inattention to personal hygiene.

The diet should be high in fluid intake and carbohydrate content and low in fats. If the patient has cirrhosis, protein intake may be limited. Dietary supplements usually include vitamin preparations, especially the B complex vitamins. If the patient is unable to cooperate by taking fluids and food by mouth, tube feeding and intravenous fluids may be necessary. Tranquilizing agents and sedatives are useful for therapy.

de·lir·i·um tre·'mens (DTs, DT),

a severe, sometimes fatal, form of delirium due to alcohol withdrawal following a period of sustained intoxication.
[L. pres. p. of tremo, to tremble]

delirium tremens

(trē′mənz)
n.
An acute, sometimes fatal episode of delirium usually caused by withdrawal or abstinence from alcohol following habitual excessive drinking. It also may occur during an episode of heavy alcohol consumption.

delirium tremens (DTs)

an acute and sometimes fatal psychotic reaction caused by abrupt cessation of excessive intake of alcoholic beverages. Initial symptoms include loss of appetite, insomnia, and general restlessness, which are followed by agitation; excitement; disorientation; mental confusion; vivid and often frightening hallucinations; acute fear and anxiety; illusions and delusions; coarse tremors of the hands, feet, legs, and tongue; fever; increased heart rate; extreme perspiration; GI distress; and precordial pain. The episode, which usually constitutes a medical emergency, typically lasts from 3 to 6 days and is generally followed by a deep sleep. See also alcohol withdrawal syndrome, Korsakoff's psychosis.

DTS

Abbreviation for:
danger-to-self
Data Transfer Service, see there 
delirium tremens
diphtheria toxin sensitivity
dipyridamole thallium scintigraphy

delirium tremens

Complicated alcohol abstinence Alcoholism An acute organic psychosis seen 3-10 days after abrupt alcohol withdrawal Clinical Confusion, sensory overload, hallucinations–eg snakes, bugs, tremor, seizures, autonomic hyperactivity, cardiovascular defects, diaphoresis, dehydration Lab ↓ K+, Mg2+ Management Hallucinations require hospitalization and haloperidol; abrupt alcohol withdrawal requires CNS depressants–eg benzodiazepines, phenobarbital; antipsychotics–eg clopromazine should not be used; anticonvulsants are not used in absence of seizure history. See Othello syndrome.

de·lir·i·um tre·mens

(DTs) (dĕ-lir'ē-ŭm trē'mĕnz)
A severe, sometimes fatal, form of delirium due to alcoholic withdrawal after a period of sustained intoxication.
Synonym(s): oenomania.

delirium tremens

A dramatic condition sometimes affecting people on withdrawal from heavy alcohol indulgence. There are purposeless body movements, shakiness, tremor, incessant and sometimes incoherent talk and a sense of threat. Vivid, unpleasant hallucinations occur. The affected person may see terrifying sights, smell horrifying smells, feel distressing touchings or hear threatening or frightening sounds or speech. Often a major seizure occurs.

Delirium tremens

A complication that may accompany alcohol withdrawal. The symptoms include body shaking (tremulousness), insomnia, agitation, confusion, hearing voices or seeing images that are not really there (hallucinations), seizures, rapid heart beat, profuse sweating, high blood pressure, and fever.

Morel,

Bénédict A., French psychiatrist, 1809-1873.
Kraepelin-Morel disease - see under Kraepelin
Morel disease - alcohol withdrawal. Synonym(s): delirium tremens
Morel ear - a large, misshapen, outstanding auricle with obliterated grooves and thinned edges.
Stewart-Morel syndrome - Synonym(s): Morgagni syndrome

de·lir·i·um tre·mens

(dĕ-lir'ē-ŭm trēm'enz)
Severe, sometimes fatal, form of delirium due to alcohol withdrawal following a period of sustained intoxication.
References in periodicals archive ?
En estos pacientes es necesario realizar un tamizaje e identificacion de factores de riesgo para sindrome de abstinencia, delirium tremens y encefalopatia de Wernicke, con el fin de promover una identificacion oportuna y un tratamiento temprano para prevenir complicaciones, aumento en mortalidad y de costos de salud.
For one of these patients, the clinical diagnosis was delirium tremens, but when death occurred this had largely cleared up; for six, the diagnosis was chronic, and for two acute, alcoholism; for two cirrhosis of the liver.
10] Mortality rates for delirium tremens have been estimated to range from 5 to 15%.
For example, alcoholism could determine a taste and preference for alcohol, a utility function favoring the maximization of alcohol consumption, a goal to consume as much alcohol as possible, a consistent transitive preference for alcohol, and even an individual's sense that alcohol consumption is in his or her immediate self-interest, at least when going into delirium tremens.
Some were admitted on verge of delirium tremens, having had been heavy drinkers for years.
THIS PASSAGE OF TIME is extended in Lipsky's adaptation: The playwright uses material from Big Sur--a later Kerouac novel which finds the 40-year-old Jack suffering from delirium tremens and lamenting the price of his literary fame--to devise poignant monologues in which the older Jack (David Zoffoli) reflects on the loss of his hometown and his first love.
The presence of alcohol or other drug-related consequences, such as drug overdose, delirium tremens, episodes of inpatient drug or alcohol treatment, evidence of medical concerns about addiction, and DWI or other alcohol- or drug-related arrests.
01) were due directly to alcohol (intoxication/falls 7, delirium tremens 2, self-neglect 2, neuropathy 1, self-poisoning by alcohol/drugs 1).
Vitamin B1 deficiency: When the body is deficient in thiamine psychiatric disturbances such as delirium tremens, impaired gait, mental confusion, hallucinations, fatigue and ocular degeneration ensue.
Tambien un extraordinario periodista que nos ha dado documentos de gran valia como Delirium tremens, en derredor este de los demonios no menos lobregos de la dipsomania, El sueno de Bernardo Reyes es mas especificamente una novelahistorica-reportaje, en cuanto el sabio poligrafo juarense se mueve con maestria en esta especie de subgenero a medio camino en el que el se ha hecho un verdadero especialista.
The symptoms range from minor ones such as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens.