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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Delirium tremens is a severe withdrawal reaction in a patient who has drunk heavily for several years.

There may be a 24-hour prodromal period in which the patient may be apprehensive, experience mild disorientation, and may fit.

The features of delirium tremens are:

  • delirium:
    • often worse at night
    • disorientation in time and place
    • clouding of consciousness
    • impairment of recent memory
    • agitation

  • gross tremor of the hands

  • sympathetic overactivity:
    • sweating
    • raised blood pressure
    • hypertension
    • pupil dilatation

  • hallucinations/pseudohallucinations:
    • often visual, also aural
    • the content is often frightening

  • dehydration and disturbed blood biochemistry:
    • leucocytosis
    • raised ESR
    • poor liver function tests

The patient usually is usually much improved after 36 hr.

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