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Delirium tremens

  • Alternative Names

    DT's; Alcohol withdrawal - delirium tremens


    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

    Signs and tests

    Delirium tremens is a medical emergency.

    The health care provider will perform a physical exam. Signs may include:

    • Heavy sweating
    • Increased startle reflex
    • Irregular heartbeat
    • Problems with eye muscle movement
    • Rapid heart rate
    • Rapid muscle tremors

    The following tests may be done:

    • Chem-20
    • Electrocardiogram (ECG)
    • Electroencephalogram (EEG)
    • Toxicology screen