Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Delirium tremens (DTs) is a severe disturbance of the brain caused by alcohol withdrawal. They are thought to occur in about 5% of patients hospitalized for alcohol withdrawal.

Adult Brain

Brain Man Face
The sudden withdrawal or decrease of alcohol can cause severe disturbances in the brain.
© 2011 Nucleus Medical Media, Inc.

Causes

DTs occur when a person who repeatedly drinks large amounts of alcohol suddenly stops or decreases the amount of alcohol consumed.

Risk Factors

These factors increase your chance of developing DTs:

  • History of DTs
  • Other medical problems in addition to alcohol abuse
  • Brain damage

Symptoms

Symptoms usually begin 2-4 days after suddenly stopping or decreasing alcohol intake. Symptoms may include:

  • Anxiety
  • Confusion / disorientation
  • Delirium (alternating levels of consciousness)
  • Trouble sleeping
  • Bad dreams
  • Severe agitation
  • Fever
  • Hallucinations (the perception of a thing, voice, or person that is not present, both visual and auditory)
  • Delusions (a false belief that is strongly held)
  • Tremors of the hands, head, or body
  • Severe sweating
  • Rapid heartbeat
  • Nausea
  • Increased rate of breathing
  • Increased blood pressure
  • Increased body temperature
  • Seizures

In severe cases, DTs can result in death, especially if untreated.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. The diagnosis of DTs is usually based on the symptoms and signs of the disorder. Tests may include:

  • Blood tests to measure liver function or electrolytes
  • CT scan —a type of x-ray that uses a computer to make pictures of the inside of the brain
  • MRI scan —a test that uses magnetic waves to make pictures of structures inside the brain
  • Electroencephalogram (EEG)—a test used to evaluate brain function or disorders

Treatment

Treatment can be difficult. DTs are likely to last for 5-7 days regardless of the therapy used. Clearing of DTs may begin in 12-24 hours, but may take up to 2-10 days. Treatment for alcohol abuse is necessary once DTs are under control.

Treatment may include:

Medication

Medicines may include:

  • Sedatives to:
    • Calm agitation
    • Ease withdrawal symptoms
  • Aspirin or acetaminophen to lower fever
  • Anti-seizure medicine

Vitamins and Fluids

Severe, life-threatening vitamin deficiency or dehydration may accompany DTs. Treatment may include:

  • Intravenous fluids, magnesium , and glucose
  • Intravenous doses of vitamin C and B-complex vitamins, including thiamin and folic acid

Rehabilitation

Treatment for alcohol abuse may be done in a hospital setting or while living at home. It may involve individual or group therapy . Many people seek support by participating in groups, like Alcoholics Anonymous (AA).

If you are diagnosed as experiencing DTs, follow your doctor's instructions .

Prevention

To prevent having DTs, do not abuse alcohol. If you do drink large amounts on a regular basis, do not suddenly decrease the amount or stop drinking on your own. Rather, get advice from your doctor on the safest way to lower your intake.