No matter how sad it may be, but in our country a lot of people suffer from alcoholism. There are cases that lead to death. Many of you have probably heard about such a dangerous disease as delirium tremens. What it is? In medicine, this condition is also called meth-alcohol psychosis. It is observed in people who consume alcohol in large quantities for a long period.
Delirium alcoholic is a serious illness with dangerous symptoms. One of its most characteristic features are hallucinations. In this condition, the patient requires urgent hospitalization and treatment under the supervision of specialists.
Description of the disease
What is delirium tremens? The ICD, or International Classification of Diseases, describes delirium as a mental disorder resulting from the abuse of alcohol. This pathology develops after 7–9 years of regular alcohol intake. In some cases, deliriumobserved in those people who do not suffer from alcoholism. Symptoms of the disease appear after a sharp refusal of alcohol.
Types of diseases
Let's take a closer look at them. Alcoholic delirium syndrome usually develops in stages. Depending on the type of pathology, the treatment regimen and types of drugs are determined.
Specialists distinguish the following types of disease:
- Classic alcoholic delirium: clinical manifestations come on gradually. Pathology goes through several stages.
- Lucid delirium: this type of disease is characterized by an acute initial stage, delirium, increased anxiety, coordination disorders, causeless fear, tremor. Hallucinations are usually absent.
- Abortive delirium: accompanied by fragmentary hallucinations, fragmentary, ill-formed delusions. The patient in this state has a pronounced anxiety. This type of illness can easily turn into another form of psychosis.
- Occupational delirium: the development of psychosis is similar to delirium tremens. Gradually, hallucinations and delusions are reduced, in the clinical picture of the disease, repetitive systematic movements associated with the professional activity of a person begin to prevail.
- Mussing delirium: this disease can develop after occupational and other forms. Obvious signs are severe clouding of consciousness, movement disorders, somatovegetative disorders.
- Atypical delirium: seen in patients who have previously had otherforms of the disease.
Causes of disease
Let's dwell on this aspect in more detail. What can cause delirium tremens? What it is? The main factor in the development of this pathology is alcoholism. Also, the disease can appear due to the use of low-quality alcoholic beverages, such as technical liquids, pharmacological preparations and alcohol surrogates. Another cause of delirium is traumatic brain injury. However, according to doctors, chronic intoxication of the body and metabolic disorders in the brain are of decisive importance.
Increases the likelihood of delirium tremens mental or physical stress. Often the disease develops when the patient is injured and ends up in the hospital. Due to the fact that alcohol ceases to enter the body, an abstinence syndrome develops. A change of scenery, physical pain and discomfort also have a great influence. A similar situation develops when alcoholic patients are admitted for treatment to a gastroenterological or cardiological department.
At home, delirium can develop after a sharp withdrawal from binge against the background of exacerbation of somatic disorders.
Symptoms
So what do you need to know about this? How is the diagnosis of delirium tremens diagnosed? All signs of the disease are divided into mental and somatic. As a rule, they appear simultaneously, so doctors in 100% of cases make the correct diagnosis. The most striking symptom is hallucinations. The patient may see fantastic creatures, animals or insects. Some feel like someone is crawling over their body. The main danger of this condition is that the patient can injure himself due to false sensations.
Alcoholic psychosis also has physiological symptoms. These include:
- heavy sweating;
- hand tremor;
- facial redness;
- HR over 100 beats;
- high blood pressure;
- shortness of breath;
- vomit;
- heat;
- headache;
- convulsions.
Simultaneously with physiological symptoms appear mental. This group of signs is associated with brain damage. These include:
- panic feeling of fear;
- nonsense;
- insomnia;
- nightmares;
- visual;
- tactile and auditory hallucinations;
- excessive arousal;
- disorientation in space and time.
Stages
So what are they? Alcoholic delirium (delirium tremens) has several stages of development. Each of them has its own characteristic features. Therapy is usually prescribed taking into account the patient's condition. Therefore, correct diagnosis at the initial stage is extremely important.
Let's take a closer look at the description of each of the stages:
- Initial. It is characterized by disturbances in the emotional state of a person. It is changing very quickly. Anxiety and anxiety are replaced by euphoria. Depression and despondency can also suddenly set in. The speech and facial expressions of the patient remain alive. To an outside observer, it may seem that the person is just a little worried. Any stimulus can cause an acute reaction, whether it be sharp sounds, smells or flashes of light. The patient can talk about vivid images and memories that arise in his mind. Fragmentary visual and auditory hallucinations are also noted. The patient often wakes up at night and feels a pronounced anxiety.
- The appearance of hallucinations. At this stage, delirium tremens (according to ICD-10, code F10.4 is assigned to it) can already be clearly diagnosed. All symptoms of the disease become more pronounced. There are such signs of psychosis as visual, auditory, gustatory and tactile hallucinations. Visual delirium manifests itself in the form of insects attacking the patient. In some cases, patients see images of deceased relatives. Simultaneously with this symptom, there is usually a sharp increase in body temperature, blood pressure and heart rate. In the presence of concomitant pathologies, such as severe trauma, depression, or previous delirium, the second stage progresses and passes into the third.
- True hallucinatory alcoholic delirium. Assistance to the patient at this stage of the disease can be provided only in the conditions of inpatient treatment. Therapy includes medication and physiotherapy methods. At the stage of true delirium, the patient ceases to adequately respond to external stimuli, his speech becomes quiet and incoherent. Blood pressure drops dramaticallyconvulsions, tremor, shortness of breath begin. In severe cases, the patient may even fall into a coma. Sometimes, with severe cerebral edema, a fatal outcome is possible. Irreversible destructive processes occur in many internal organs.
How to independently recognize alcoholic delirium (according to ICD-10, F10.4)? The main sign of intoxication is a seizure similar to an epileptic one. It can occur both after drinking alcohol, and with a sharp rejection of it. The patient also has difficulty breathing, hoarseness, blue area around the mouth and nose, loss of consciousness, rolling eyes, foaming at the mouth, vomiting, unnatural postures. When the patient wakes up, he behaves extremely harshly and aggressively. Visual, memory, and hearing impairments may also occur.
Treatment
Where should I start first? Now that you know about such a disease as delirium tremens - what it is, as well as its main symptoms, you can start talking about treatment. In this condition, the patient requires intensive drug therapy and quality care. In some cases, resuscitation is necessary. Treatment of delirium is usually carried out on the basis of a neuropsychiatric hospital. The patient's condition should be monitored by a therapist and resuscitator. Prescribed methods and drugs may vary depending on the clinical picture of the disease.
Symptom relief
What is this? How to treat alcoholic delirium (code, according to ICD-10, F10.4)? When such signs appearillnesses, like hallucinations, you must immediately call an ambulance. The patient will be referred for treatment to a narcological or psychiatric dispensary, where he can receive the necessary care. Before the ambulance arrives, try to put the patient to bed. Do not leave the patient unattended, as in this state he may injure himself or others. In a medical institution, the safety of the patient can be ensured by staff.
To relieve severe symptoms, doctors usually use the following methods:
- Deep sedation: the patient is put on a ventilator until the delirium is over.
- Stopping with medications. In this case, the patient remains on spontaneous breathing.
Medicated treatment
What is it like? What drugs will be effective in the treatment of a disease such as delirium tremens? The ICD classifies the disease as quite severe, so self-medication in this case is unacceptable. An experienced doctor will help you choose a list of necessary drugs. With the wrong treatment regimen, complications may occur.
The following groups of drugs are used in medical facilities to treat delirium:
- psychotropic drugs;
- means that ensure the normal functioning of the respiratory system;
- drugs to maintain water-s alt balance;
- blood pressure medication;
- drugs for insomnia;
- drugs that normalizemetabolism;
- detoxification products;
- drugs that improve the functioning of the cardiovascular system.
Detoxification
This aspect should be given special attention. One of the mandatory steps in the fight against the disease is detoxification of the body. It is necessary to cleanse the blood and internal organs of the patient from poisons. Often, against the background of alcoholism, patients develop heart failure, disorders in the gastrointestinal tract, kidneys and liver. The most effective is the intravenous administration of drugs such as Unitol or Piracetam.
Plasmopheresis is another effective way to purify the blood for a disease such as alcohol delirium (code, according to ICD 10, F10.4). With this method, part of the patient's plasma is replaced with a special solution. This helps to achieve the maximum cleansing effect. The cells of the body are freed from poisons that lead to the development of withdrawal symptoms.
The benefits of plasmapheresis are as follows:
- metabolic processes in the brain are normalized;
- improve blood rheology;
- restoring the immune system;
- Duration of therapy is significantly reduced.
After plasmapheresis, the patient, as a rule, feels relief. An additional positive effect can be achieved by taking diuretic drugs. An important part of detoxification therapy is taking medications that are responsible for the restoration of liver cells.
Sleep normalization
How to restore the functioning of the body after such a disease as alcoholic delirium (according to ICD-10, F10.4)? One of the most important steps is to stimulate sleep. Benzodiazepines are usually used for this purpose. These drugs are officially recognized as the safest in all stages of alcoholism. The dosage is determined by the doctor. Medications should stop the main signs of alcoholic psychosis, but should not depress spontaneous breathing.
If necessary, drugs can put the patient into a state of prolonged sleep. The safest are such means as "Diazepam" and "Phenazepam". If a patient is diagnosed with abnormalities in the liver, he is recommended to use Lorazepam. The drugs of this group will help to avoid the development of a state of increased nervous excitability.
Alcoholic delirium (code, according to ICD-10, F10.4) may be accompanied by increased aggression. To combat these symptoms, antipsychotics are used. In modern medicine, taking such drugs is an additional measure if benzodiazepines do not bring the desired effect. Antipsychotics can lead to serious side effects. They lower the seizure threshold and cause hypotension.
Recovery Therapy
What is her speci alty? Alcoholic delirium (ICD 10, F10.4) is a serious disease that can inhibit the activity of various body systems. An obligatory component of treatment is the restoration of the functions of the cardiovascular, autonomic, endocrine and nervous systems. To get rid of the withdrawal symptoms, it is necessary to establish blood flow. Synthetic or herbal medicines can be used to improve cardiac activity. Normalization of blood circulation will lead to the restoration of metabolic processes, memory, hearing and neural connections.
To restore the internal forces of the body, doctors usually prescribe vitamin complexes and special medicines to cleanse the blood of alcohol breakdown products. At the recovery stage, folk methods can be used. Herbal decoctions are good for cleaning blood vessels and improving blood circulation.
Conclusion
In this review, we examined in detail the disease called delirium tremens: what it is and how to deal with it. This is a rather severe pathology that requires serious treatment in a medical institution. If you do not turn to specialists in time, the disease can cause serious complications.
