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Delirium tremens - characteristics

Author: RxPG, Posted on Thursday, June 17 @ 00:00:00 IST by RxPG  

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Psychiatry

QUESTION.
Delirium tremens is characterized by confusion associated with:
1. Autonomic hyperactivity and tremors.
2. Features of intoxication due to alcohol.
3. Sixth nerve palsy.
4. Korsakoff psychosis.
 



Answer
1. Autonomic hyperactivity and tremors.

Reference
A Short Textbook of Psychiatry by Ahuja 4 ed Page No 36

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Discussion
Delirium Tremens (DT) is the most severe alcohol withdrawal syndrome. It occurs usually within 2-4days of complete or significant abstinence from heavy alcohol drinking in 5 % of the patients, as compared to acute tremulousness which occurs in 34 % of the patients. The course is short with recovery occurring within 3 - 7 days. This is an acute organic brain syndrome with the characteristic features of
a) Clouding of consciousness with disorientation in time and place
b) Poor attention span and distractibility
c) Visual and Auditory hallucinations and illusion which are often vivid and frightening. Tactile hallucinations of insects crawling over body may occur
d) Marked autonomic disturbance with tachycardia, fever, sweating, hypertension and pupillary dilation.
e) Psychomotor agitation and ataxia
f) Insomnia, with a reversal of sleep - wake pattern.
g) Dehydration with electrolyte imbalance

Explanation
1. Autonomic hyperactivity and tremors are the features of Delirium Tremens.
2. Features of intoxication due to alcohol will not be seen in Delirium tremens. Remember that Delirium tremens occurs in “conditions of No Alcohol” and not in Alcoholic Intoxication where there are plenty of Alcohol.
3. Sixth nerve palsy is a feature of Alcoholic Intoxication.
4. Korsakoff psychosis occurs in Alcoholic Intoxication.

Comments
This question is easier to answer as choices 2,3,4 are concerned with Alcoholic Intoxication

Tips
This question and the next one given here forms an example of the “theme couple” that you so often see in All India and AIIMS question
 



Explanation by Dr Bruno, Author of

Author Dr Bruno, Publisher Jaypee



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