The Latin word delirium is translated as "madness", "dementia". Ethanol, which is found in alcohol and enters the human body naturally, is a strong neurotoxin that affects human brain cells. This leads to the formation of delirium. In the people, it is called "white tremens".
Causes of occurrence
This disease belongs to the category of psychoses. The main cause of alcoholic delirium is the refusal to use alcoholic beverages after prolonged libations by people suffering from stage II-III alcoholism. Also, the reason may be the use of an alcoholic substitute.
In the stage of intoxication with alcohol, a mental disorder does not affect the psyche, but already on 2-4 days its symptoms can make themselves felt. The body, accustomed to the presence of alcohol, reacts sharply to its absence. This factor starts the process of the disease.
Shapes
In accordance with the international classification (ICD-10) allocatethe following types of alcoholic delirium:
- Professional.
- Mussing (mumbling).
The last type of disorder is quite dangerous. In it, the patient is in bed, makes strange sounds, and also makes movements that imitate wrapping, stroking. The danger of this condition lies in the fact that it is fraught with a fatal outcome. As for the professional type, its main characteristic is this: being in a state of insanity, the patient imitates his everyday work activity. He not only makes characteristic movements, but also imitates special sounds. This form can also be fatal.
Risk groups
As a rule, the disorder develops mainly in people over 40 who regularly drink alcohol for 5-7 years. In women, this disease progresses much faster. The following groups of people are most susceptible to it:
- Women and men who have already had an episode of delirium tremens.
- Chronic alcoholics with more than 5 years of experience.
- Persons who have suffered a traumatic brain injury in the past.
- Those who have chronic infections in the acute stage.
Diagnosis
Diagnosis of alcoholic delirium occurs during a personal examination of the patient. Analyzes are taken only as the patient recovers. This is necessary in order to diagnose or exclude other somatic diseases that are caused by alcohol.poisoning.
Signs at the initial stage
In most cases, the onset of symptoms of delirium tremens is preceded by some circumstances that forced you to suddenly stop taking large doses of alcohol. The first signs of the disease may appear long before the onset of psychosis. It could be:
- Vomiting.
- Headache.
- Speech disorders.
- Convulsions.
Before the end of the binge, there may be a deterioration in physical well-being. Appetite is reduced, often there is an aversion to food. In the morning, nausea may occur, which ends in vomiting. The patient may complain of a feeling of pain and heaviness in the stomach. The dizziness gets worse. Chills may be replaced by a sensation of heat. There may also be symptoms such as numbness in the legs, pain in the heart, convulsions. Sometimes those suffering from delirium tremens seek to alleviate their condition by taking small doses of alcohol, preparing them for the night. Often the single dosage is reduced as the patient feels more and more physically weak.
Over time, other signs may appear that belong to the group of somatic manifestations.
- The skin of the face becomes reddish.
- Increased blood pressure as well as body temperature.
- Heartbeat is getting faster.
- Tremor in the hands, increased sweating.
Disease development
After the binge is stopped, the withdrawal syndrome is especiallyseverity of symptoms. There may be repeated vomiting, a feeling of suffocation in the region of the heart, and there is a fear of death. Patients can hardly sleep. Physical weakness makes it impossible to move normally around the apartment. Movements become inaccurate, awkward, coordination is disturbed. The face becomes puffy, the skin is red, sometimes a yellowish tint of the sclera is found. Pulse and respiration increase. The tongue is coated. Poor he alth is reflected in the suffering facial expressions.
Against the background of an anxious mood, irritability and aggressiveness also increase. Changes in the psyche also testify to the approaching alcoholic delirium. The condition is characterized by motor retardation, efficiency, fussiness. Depressive affect is combined with gloomy hypochondria, resentment, malice. Sometimes it is replaced by a tendency to fleeting humorous statements. Unstable ideas of paranoia, witchcraft, jealousy may arise. Vivid memories from the past emerge.
If the patient falls asleep, his dreams are characterized by anxiety and fantasy. Upon awakening, he cannot always draw a line between the real situation and what he dreamed about.
Sleep also gets worse, inexplicable anxiety arises. As the alcoholic delirium develops, the symptoms become more and more psychotic. The most acute symptoms of the disease begin to appear 3-4 days after the onset. This is:
- Hallucinations.
- Insomnia.
- Nervous excitement.
Types of hallucinations
The nature of the manifestation of terrible visions is quite individual. Conventionally, they are divided into the following groups:
- Visual.
- Tactile.
- Voices in the head (auditory).
- Delirium.
Suffering from delirium tremens, they start jumping up, muttering something, suspiciously examining the room in which they are. They have abundant illusions. Their intensity decreases with a decrease in the concentration of attention on them or with distraction. The state is constantly fluctuating. Sometimes those suffering from delirium tremens syndrome realize that something is wrong with them. However, such periods are short, neurological symptoms are unstable and precede hallucinatory obscurations. Patients may see various fantastic creatures: rats, devils, gnomes, insects, monsters. Imaginary creatures seem active to the alcoholic, constantly acting on the nerves, causing fear or aggression.
Debut
In about one-third of all cases of alcoholic delirium, which occurs for the first time, is accompanied by verbal hallucinations. They determine the patient's condition within a few hours. Often, verbal deceptions become quite detailed, systematized. There are ideas of persecution, observation, physical impact. Often, alcoholics say nothing about the content of delusions because of its offensive content, which can affect the most intimate aspects of life. Hallucination is accompaniedsignificant changes in perception, consciousness. This is evidenced by the subsequent amnesia of experiences.
It is not uncommon that what an alcoholic hears is perceived as so real that he uses the word “seen” and not “heard” to describe, for example, scenes of execution of people. Often the contents of the voices are fantastic. The patient's behavior is characterized by insufficient motivation, the desire to fulfill hallucinatory "orders". This is the manifestation of the delirious coloration of the disease. The depth of stupefaction can be so severe that patients amnesiac for long periods of time during which they made remarks to someone, gesticulated sharply, tried to defend themselves.
Therapy
Treatment of alcoholic delirium is carried out only in a hospital. In no case should you try to heal a relative or friend from the "squirrel" - if symptoms occur, you should consult a doctor. The use of unconventional methods of treatment can be fatal. Patients need urgent hospitalization.
When a patient is diagnosed with delirium tremens, the patient ends up in a narcological institution or in a psychiatric department of a hospital.
In this case, only drug therapy is used, which involves the removal of toxins from the body and the introduction of deep sleep. Rest allows you to significantly speed up recovery and restore clarity of consciousness. After taking measures of drug therapy, the patient may feel overwhelmed and memory lapses. Sometimes he can remembertheir hallucinations quite clearly, but completely forget the real events. Treatment of alcoholic delirium is carried out only inpatient, under the strict supervision of a narcologist. Sometimes the help of a psychotherapist may be appropriate.
Help with alcoholic delirium
What to do if a person is in a state of delirium tremens, and the ambulance has not yet arrived? The first thing to do is to put the patient to bed, exclude access to dangerous objects with which he can harm himself or others (in extreme cases, you can tie him to the bed). A cold compress can be applied to the head. It is necessary to give the patient as much liquid as possible. Then you need to immediately call an ambulance. There is nothing else to do before the doctors arrive.
Inpatient Therapy
When a patient is admitted to a he alth facility, the doctor may prescribe one of the following drugs:
- "Dimedrol";
- "Barbamil";
- "Diazepam";
- "Sodium oxybutyrate".
In addition, vitamins are often used for treatment, as well as medicines to restore internal organs damaged during delirium tremens.
Complications
As practice shows, the consequences of delirium tremens cannot be avoided - especially if treatment attempts are made at home. The most severe consequence of delirium is death. In other cases, possible:
- Disturbances in the work of the central nervous system, in particular the brain.
- Acute kidney failure.
- Mental disorders.
- Hearing and vision loss.
- Immune weakening.
Also, after the "delirious tremens" there may be such terrible situations as chronic delirium or coma.
Death from this disease is from 5 to 10% of the total number of cases. In most cases, cerebral edema or cardiac arrest occurs. Also, death can occur due to:
- Suicide under the influence of hallucinatory delusions.
- Accident - without realizing their actions, a person can fall under the wheels of a car or fall out of a window.
- Pulmonary edema.
- Breathing stops.
Korsakoff syndrome
Another serious complication caused by delirium. This type of psychosis usually develops in the later stages of the fever. Korsakov's syndrome is manifested in the fact that the patient does not remember relatives, does not recognize acquaintances. He constantly asks the same questions, does not understand what happened to him, is lost in the numbers and days of the week. He is accompanied by constant excitability, anxiety, indifference to the events of his own life. Often in such cases, paralysis, complete loss of efficiency.
In the presence of Korsakov's psychosis, the alcoholic gets a disability. It is already impossible to restore the working capacity of such people. But the memory may well return after a few years. However, this requires a complete rejection of alcohol, as well as high-quality and timely therapy.
The most common consequence is degradationpersonality. Just a couple of attacks of delirium are enough for this process to become irreversible - after all, under the influence of alcohol, neurons are destroyed en masse.
"Delirium tremens" is quite a serious disease. When its first symptoms occur, in no case should you hesitate. After all, calling an ambulance too late can cost an alcoholic his life.
