MENTAL ILLNESS : DELIRIUM TREMENS (DELIRIUM TREMENS) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Etiology. Occurs exclusively on the grounds of chronic alcoholism. Intermediate etiological factor is often a disorder of metabolism, in particular, disruption of the liver. Predisposing causes are considered to be febrile illness, sudden emotional excitement.
Symptoms. Numerous hallucinations, mainly visual in nature, monotonous, different theatrical effectiveness, mobility. Hallucinations lead to delusional twisted interpretation of reality. Patients often reenact scenes, showing their typical activities (professional delirium). Rather characterized by a combination of fear and humor. Motor and speech anxiety. Consciousness changed: orientation, especially in the place, upset. Hand tremors, increased sensitivity to painful stimuli, often epileptiform seizures, especially in early disease, severe sleep disturbance, fear.
During acute bouts are held for 3 to 8 days. Recovery occurs immediately during sleep (so-called critical sleep). In 5 to 10% die from the weakening of the cardiac activity.
Alcoholic hallucinosis is characterized by the fact that during the last clear consciousness, systematized delusions.
In the early days, referring to the sudden escape attempts, attempts to commit suicide, is bed rest and careful supervision. Particular attention should be paid to cardiac activity; assign strophanthus, camphor, caffeine, digitalis.
At elevated temperatures (above 39º): cool baths (about 20°) for 5 - 10 minutes, wash your head with cold water. For edema delirium tremens resort to bringing critical sleep.
If the patient wakes up, immediately give 0.1 - 0.2 luminal.
It should be borne in mind that frequent the Lodge of chloral hydrate may lead to addiction and to lower blood pressure. Do not use opiates cause constipation, as well as body wraps, which often reinforce the fear. In order to reduce acidosis caused by hunger and motor excitation, and to replenish water losses caused by sudden sweating, it is recommended that dairy meals and drink plenty of water, especially alkaline water.
With a sharp concern: