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.

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 ?
Remission was positively related to working class status and to some serious mental disorders, such as delirium tremens, substance-induced psychotic disorders, organic disorders and dementia.
Los pacientes con sindrome de abstinencia con mayor riesgo de desarrollar delirium tremens son aquellos que presentan: historia previa de delirium tremens o convulsiones, presencia de convulsiones en el cuadro de abstinencia y frecuencia cardiaca al ingreso mayor de 100 latidos/ minuto.
Refractory delirium tremens treated with propofol: A case series.
The oddest could be Delirium Tremens, a Belgian ale in a blue foil bottle decorated with grinning pink elephants ($3.89).
Suppression of alcohol delirium tremens by baclofen administration: a case report.
Feltenstein believed wrongly that Dylan had delirium tremens and instead of admitting him to hospital injected him with morphine impairing his respiratory system still further.
Sedative-hypnotic agents are more effective than neuroleptic agents in reducing mortality in alcohol withdrawal delirium popularly known as delirium tremens.
Although Alexander had an appetite for alcohol, his terminal illness is inconsistent with liver failure attributable to alcoholic cirrhosis or delirium tremens. Poisoning, which has been postulated by some, is not a reasonable diagnostic possibility either, since toxins or poisons are not accompanied by fever.
Thus Conducteur D, 2001, a nightmare of good form and successful composition, makes me think, not without a tinge of jubilation, of some Swiss Concrete artist seized by violent delirium tremens. But the high point of the exhibition was the almost complete presentation of two large series, "Lucky" and "portable" (both 2000), Almost--because, in an echo of the paradoxical logic according to which Jumelle was included, one canvas had been omitted from each.
The baby went through the DTs delirium tremens as the alcohol passed from his system, although it was not known if he would suffer lasting problems.
They went 'on the game' at puberty and survived on pitiful earnings, riddled with VD, until they were wrecked by beatings, hunger and delirium tremens.'
Heather Kirk Thomas is also concerned with the contemporary context in her essay, '"A kind of 'debased Romanesque' with delirium tremens": Late Victorian Wall Coverings and Charlotte Perkins Gilman's "The Yellow Wallpaper"', and again links Gilman to Wharton in their common concern about the 'bric-a-brac habit' that dominates the American drawing room.