Delirium tremens Health Article

Definition

Delirium tremens is a severe form of alcohol withdrawal that involves sudden and severe mental or neurological changes.

Alternative Names

DT's; Alcohol withdrawal - delirium tremens

Causes, incidence, and risk factors

Delirium tremens can occur after a period of heavy alcohol drinking, especially when the person does not eat enough food.

It may also be triggered by head injury, infection, or illness in people with a history of heavy alcohol use.

It is most common in people who have a history of alcohol withdrawal. It is especially common in those who drink the equivalent of 4 - 5 pints of wine or 7 - 8 pints of beer (or 1 pint of "hard" alcohol) every day for several months. Delirium tremens also commonly affects those who have had a history of habitual alcohol use or alcoholism for more than 10 years.

Symptoms

Symptoms most commonly occur within 72 hours after the last drink, but may occur up to 7 - 10 days after the last drink. Symptoms may get worse rapidly, and can include:

• Body tremors
• Mental status changes
  • Agitation, irritability
  • Confusion, disorientation
  • Decreased attention span
  • Decreased mental status
    • Deep sleep that persists for a day or longer
    • Stupor, sleepiness, lethargy
    • Usually occurs after acute symptoms
  • Delirium (severe, acute loss of mental functions)
  • Excitement
  • Fear
  • Hallucinations (such as seeing or feeling things that are not present are most common)
  • Highly sensitive to light, sound, touch
  • Increased activity
  • Mood changes rapidly
  • Restlessness, excitement
• Seizures
  • Most common in first 24 - 48 hours after last drink
  • Most common in people with previous complications from alcohol withdrawal
  • Usually generalized tonic-clonic seizures
• Symptoms of alcohol withdrawal
  • Anxiety
  • Depression
  • Difficulty thinking clearly
  • Fatigue
  • Feeling jumpy or nervous
  • Feeling shaky
  • Headache, general, pulsating
  • Insomnia (difficulty falling and staying asleep)
  • Irritability or easily excited
  • Loss of appetite
  • Nausea
  • Pale skin
  • Palpitations (sensation of feeling the heart beat)
  • Rapid emotional changes
  • Sweating, especially the palms of the hands or the face
  • Vomiting

Additional symptoms that may occur:

• Chest pain
• Fever
• Stomach pain