Alcohol withdrawal delirium - diagnosis, course and treatment

Mainerova, B.; Praško, Ján; Látalová, Klára; Axmann, K; Cerna, Monika; Horáček, Rostislav; Bradacova, Romana

doi:10.5507/bp.2013.089

Cited by 73 publications

(98 citation statements)

References 115 publications

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“…Physical examination and investigations should be directed toward detecting common signs and symptoms of AWS that are listed in Table 1 6, 10, 14, 15, 16, 17, 18…”

Section: Clinical Spectrummentioning

confidence: 99%

“…In minor withdrawal, patients always have intact orientation and are fully conscious. Symptoms start around 6 h after cessation or decrease in intake and last up to 4–48 h (early withdrawal) 6, 10. Hallucinations of visual, tactile or auditory qualities, and illusions while conscious are symptoms of moderate withdrawal.…”

Section: Clinical Spectrummentioning

confidence: 99%

“…They can last up to 6 d. The appearance of acute symptomatic seizures may emerge 6–48 h after the last drink 19. Delirium tremens (DT, onset 48–72 h after cessation of drinking) represents characteristics of severe withdrawal that may last for up to 2 weeks (late withdrawal) 6, 10, 15, 18. The chronological development of the various symptoms is illustrated in Fig.…”

Section: Clinical Spectrummentioning

confidence: 99%

“…Delirium is a clinical syndrome of acute onset characterized by a global confusional state, perceptual abnormalities, and somatic symptoms of vegetative or central nervous presentation 6. Hallucinosis represents a unique form of withdrawal‐related psychosis which can begin even while the person is continuing to use alcohol or after cessation of drinking.…”

Section: Clinical Spectrummentioning

confidence: 99%

“…The sensorium is clear in the beginning, but it often evolves into the syndrome of DT, a specific type of delirium typically associated with psychomotor agitation (hyperactive delirium) which emerges during the late withdrawal phase 14, 18. Delirium can also manifest as a hypoactive state with decreased arousal and psychomotor activity, which is associated with a worse prognosis, delayed diagnosis and treatment as well as later complications 6. In cases of hypoactive delirium, comorbid or other medical illnesses must be ruled out.…”

Section: Clinical Spectrummentioning

confidence: 99%

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Alcohol withdrawal syndrome: mechanisms, manifestations, and management

et al. 2016

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The alcohol withdrawal syndrome is a well‐known condition occurring after intentional or unintentional abrupt cessation of heavy/constant drinking in patients suffering from alcohol use disorders (AUDs). AUDs are common in neurological departments with patients admitted for coma, epileptic seizures, dementia, polyneuropathy, and gait disturbances. Nonetheless, diagnosis and treatment are often delayed until dramatic symptoms occur. The purpose of this review is to increase the awareness of the early clinical manifestations of AWS and the appropriate identification and management of this important condition in a neurological setting.

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“…Physical examination and investigations should be directed toward detecting common signs and symptoms of AWS that are listed in Table 1 6, 10, 14, 15, 16, 17, 18…”

Section: Clinical Spectrummentioning

confidence: 99%

Section: Clinical Spectrummentioning

confidence: 99%

Section: Clinical Spectrummentioning

confidence: 99%

Section: Clinical Spectrummentioning

confidence: 99%

Section: Clinical Spectrummentioning

confidence: 99%

See 3 more Smart Citations

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

et al. 2016

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Quantitative electroencephalographic analysis of delirium tremens development following alcohol‐withdrawal seizure based on a small number of male cases

Yoon

Kim

et al. 2022

Brain and Behavior

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Introduction: Seizures and delirium tremens (DTs) are recognized as severe alcoholwithdrawal symptoms. Prolonged admission and serious complications associated with alcohol withdrawal are responsible for increased costs and use of medical and social resources. This study investigated the predictive value of quantitative electroencephalography (QEEG) for developing alcohol-related DTs after alcohol-withdrawal seizure (AWS).Methods: We compared differences in QEEG in patients after AWS (n = 13). QEEG was performed in the intensive care unit within 48 h of admission, including in age-and sex-matched healthy controls. We also investigated the prognostic value of QEEG for the development of alcohol DTs after AWS in a retrospective, case-control study. The spectral power of each band frequency and the ratio of the theta to alpha band (TAR) in the electroencephalogram were analyzed using iSyncBrain ® (iMediSync, Inc., Korea). Results:The beta frequency and the alpha frequency band power were significantly higher and lower, respectively, in patients than in age-and sex-matched healthy controls. In AWS patients with DTs, the relative beta-3 power was lower, particularly in the left frontal area, and the TAR was significantly higher in the central channel than in those without DTs. Conclusion:Quantitative EEG showed neuronal excitability and decreased cognitive activities characteristic of AWS associated with alcohol-withdrawal state, and we demonstrated that quantitative EEG might be a helpful tool for detecting patients at a high risk of developing DTs during an alcohol-dependence period.

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Attention‐deficit hyperactivity symptoms and risk of alcohol use relapse

Kawata

Sugihara

Kakibuchi³

et al. 2022

Neuropsychopharm Rep

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Aim Alcohol use disorder (AUD) is frequently accompanied by comorbid attention‐deficit hyperactivity disorder (ADHD). Comorbid ADHD has been reported to increase the severity of AUD. We investigated whether ADHD severity also influences AUD relapse risk at baseline and after inpatient treatment. Methods In this study, 187 AUD patients admitted to Narimasu Kosei Hospital from October 2019 to March 2021 were included in the analysis. According to the Adult ADHD Self‐Report Scale (ASRS), participants were divided into two groups: ASRS+ with ADHD characteristics (n = 43) and ASRS− with low/no ADHD characteristics (n = 144). Groups were compared for AUD relapse risk at the start of treatment (baseline) and before hospital discharge using the multidimensional Alcohol Relapse Risk Scale (ARRS). The change in relapse risk during hospitalization was also compared by assessment of the interaction between groups (ASRS+ vs. ASRS−) and time (at discharge vs. baseline). Results The total ARRS score and dimension subscores for stimulus‐induced vulnerability and emotionality problems were significantly higher in the ASRS+ group at baseline and before discharge compared to the ASRS− group. There was a significant group × time interaction indicating less improvement of stimulus‐induced vulnerability during inpatient treatment among the ASRS+ group compared to the ASRS− group. Conclusions Our findings suggest that AUD patients with ADHD characteristics have a higher risk of relapse both at baseline and after inpatient treatment. Stimulus‐induced vulnerability to relapse is less likely to improve with treatment in patients with ADHD characteristics.

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Alcohol withdrawal delirium - diagnosis, course and treatment

Cited by 73 publications

References 115 publications

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

Alcohol withdrawal syndrome: mechanisms, manifestations, and management

Quantitative electroencephalographic analysis of delirium tremens development following alcohol‐withdrawal seizure based on a small number of male cases

Attention‐deficit hyperactivity symptoms and risk of alcohol use relapse

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