alcohol withdrawal delirium


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 consciousness" >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" >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.

al·co·hol with·draw·al de·lir·i·um

the delirium experienced by a person habituated to alcohol consumption that is caused by the abrupt cessation of alcohol intake.

al·co·hol with·draw·al de·lir·i·um

(alkŏ-hol with-drawăl dĕ-lirē-ŭm) Mental state experienced by a person habituated to alcohol consumption that is caused by the abrupt cessation of alcohol intake.
Compare: delirium tremens