Delirium tremens

The Délirium tremens is the consequence most severe Neurologique of the Syndrome of weaning of alcohol.

It is a state of agitation with fever, tremors of the members, onirism and disorder of the conscience, suitable for the alcoholic intoxication.

The delirium tremens occurs only at the alcoolodépendants during a weaning of alcohol not controlled by an effective cure of weaning.

Clinical signs

The clinical picture is characterized by signs of traditional weaning to which a confuso-oneiric syndrome is added associating a confusion temporospatiale, a Obnubilation and a Délire. Visual Hallucination S putting in scene animals (Zoopsie S) there are very frequently associated like on the sexual, family or professional topic.

Convulsives crises are frequent in the first 48 hours. Without treatment, the risk of death can go until 15 % according to the studies. The whole of symptomatology is source of Anxiété and agitation being able to be at the origin of aggressive acts.

The subject is also very sensitive to the environment. This is why it is important to reassure it by the voice and the behavior.

Treatment

It consists of:

rehydration by venous parenteral way by a standard aqueous solution glucose with 5 % + 4 G NaCl + 2 G KCl;
vitamin therapy B1B6 which does not prevent, nor does not even treat the delirium tremens him but which prevents the risk of Syndrome of Korsakoff or of Gayet-wernicke. It is essential the more so as a perfusion of glucose is installation (vitamin dépletion induced by glucose);
the physical Contention which must remain limited to the cases where it exists a risk of pulling up of the perfusion;
sedation by Benzodiazépine with half long life, which constitutes the treatment of the delirium tremens;
environment calms less possible Anxiogène: lit room, reassuring words, few noises;
monitoring regular nurse.

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