Delirium tremens (“DTs”, severe alcohol withdrawal)

Description A complication of c...

Description

A complication of chronic alcohol abuse. It is characterized by excessive agitation, confusion, and hallucinations. There is a release in adrenalin and other catecholamines after a sudden deprivation of alcohol. Not all alcoholics experience DTs when they stop drinking alcohol, but recurrence of DTs is common. If left untreated DTs can result in death.

Symptoms

Hallucinations, confusion, sweating, elevated blood pressure, racing heart, agitation, seizure.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed, Tests are performed to rule out other causes of the confusion and hallucinations. Alcoholics have a higher incidence of infections and traumatic brain injuries and these possibilities are usually ruled out before the diagnosis is of DTs is confirmed.

Tests:
Pregnancy (BHCG) test, Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Lipase, Troponin, Urinalysis (UA), X-ray

Other Specific Tests: Blood alcohol level

Specialists:
Medical Toxicology

Treatment

Intravenous fluids, treatment of fever, and sedation are the mainstays of therapy. Benzodiazepines (lorazepam, diazepam) are administered and large doses are occasionally needed. Other sedatives, anti-psychotic medications (such as haloperidol) and anti-seizure medications may be administered. Patients often need treatment in an ICU. High mortality if not treated quickly and aggressively.