delirium tremens

delirium tremens
   Also known as shaking delirium and Saunders-Sutton syndrome. The term delirium comes from the Latin verb delirare, which means to go off the furrow, to derail. The adjective tremens is Latin for trembling or shaking. The expression delirium tremens is used to denote a subtype of " delirium that may occur following the cessation of a prolonged and excessive intake of alcohol, benzodiazepines, barbiturates or other tranquillizers. The term was introduced in 1813 by the British physician Thomas Sutton (1767-1835), who used it to demarcate the concomitant cluster of symptoms from other types of delirium, as well as from other alcohol withdrawal syndromes. The eponym Saunders-Sutton syndrome refers to Sutton and to his Scottish colleague Willam Saunders (1743-1817), who had lectured on the subject, and gave Sutton advice while he was preparing his original paper on the subject. According to the historians of psychiatry Gregory Zilboorg (1890-1960) and George W. Henry (1890-1964), the symptoms characteristic of delirium tremens have been known since prehistoric times, as has their association with alcohol withdrawal. The clinical symptoms of delirium tremens include tremor, tachycardia, tachypnea, either hypertension or hypotension, increased perspiration, an alteration ofbody temperature, gastritis, vomiting, disorientation, hyperkinesis, anxiety, panic attacks, agitation, insomnia, food aversion, confabulations, paranoia, hallucinations, "illusions, "paraesthesias, epileptic seizures, and coma. The hallucinations occurring in the context of delirium tremens are primarily of a "complex visual or "compound nature. They tend to consist of vivid, terrifying images of people, animals (i.e. "zoopsia) or insects that can be felt crawling upon or beneath the skin (i.e. "formication). A special type of visual hallucination described in the context of delirium tremens that can be evoked by the covering of one eye is the "monocular hallucination. As pointed out by the Swiss psychiatrist Ferdinand Morel (1888-1957), many of the " visual illusions (and perhaps also hallucinations) in delirium tremens are associated with the presence of a positive "scotoma, which can be described adequately by the affected individual during sober phases, but which may act as a "point de repère for their development when consciousness is clouded. The symptoms of delirium tremens typically arise several days to a week after the cessation of a prolonged episode of excessive alcohol intake. Without adequate treatment these symptoms may last for several weeks. As noted by 19th-century authors, untreated delirium tremens is always self-limiting, in the sense that it ends either in spontaneous recovery or death. The mortality rate of untreated delirium tremens is estimated to lie between 15 and 40%. Even with adequate treatment, the mortality rate is between 1 and 15%. The pathophysiology of delirium tremens is largely unknown, but it is attributed mainly to the central effects of alcohol on the benzodiazepine-GABAA-chloride receptor complex for the neurotransmitter gamma amino butyric acid (GABA). The high mortality rate is associated primarily with comorbid conditions such as hyperthermia, dehydration, vitamin depletion, electrolyte disturbances, cardiac arrhythmia, cardiac failure, and hepatic coma.
   References
   Cutshall, B.J. (1965). The Saunders-Sutton syndrome: An analysis of delirium tremens. Quarterly Journal of Studies on Alcohol, 25, 423-448.
   David, N.F. (1976). Hallucinations during delirium tremens. Journal ofthe American Medical Association, 235, 1688.
   Madden, J.S. (1995). Substance use disorders. Clinical section.In: A history of clinical psychiatry. The origin and history ofpsychiatric disorders. Edited by Berrios, G.E., Porter, R. London: Athlone.
   Morel, F. (1937). Hallucination et champ visuel. De la texture, de la forme, de la multiplicité, des mouvements que présentent les hallucinations visuelles du delirium tremens. Annales Médico-psychologiques, 95, 742-757.
   Zilboorg, G., Henry, G.W. (1941). A history of medical psychology. New York, NY: W.W. Norton & Company.

Dictionary of Hallucinations. . 2010.

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  • Delirium Tremens — Pour les articles homonymes, voir Delirium tremens (homonymie). Le delirium tremens est une conséquence neurologique sévère du syndrome de sevrage d alcool. C est un état d agitation avec fièvre, tremblements des membres,onirisme et trouble de la …   Wikipédia en Français

  • Délirium trémens — Delirium tremens Pour les articles homonymes, voir Delirium tremens (homonymie). Le delirium tremens est une conséquence neurologique sévère du syndrome de sevrage d alcool. C est un état d agitation avec fièvre, tremblements des membres,onirisme …   Wikipédia en Français

  • DELIRIUM TREMENS — Une des complications majeures de l’alcoolisme chronique. Le delirium tremens survient notamment lors du sevrage brutal et accidentel consécutif à un accident, à une maladie aiguë, à une intervention chirurgicale. Il réalise ici le «syndrome de… …   Encyclopédie Universelle

  • delirium (tremens) — ⇒DELIRIUM (TREMENS), subst. masc. MÉD. Épisode aigu de l alcoolisme chronique, caractérisé par un état confusionnel, une agitation et une angoisse extrêmes, des tremblements généralisés, des sueurs profuses. Synon. délire aigu alcoolique. • 1.… …   Encyclopédie Universelle

  • Delírium tremens — Saltar a navegación, búsqueda Para otros usos de este término, véase Delirium Tremens (desambiguación). Delírium tremens Clasificación y recursos externos …   Wikipedia Español

  • delirium tremens — m. intox. Alteración intensa del estado neurológico caracterizado por temblores, taquicardia, sudoración, irritabilidad y alucinaciones visuales. Se produce en enfermos agudos, traumatismos y en alcohólicos crónicos. Si la crisis es muy aguda… …   Diccionario médico

  • Delirium Tremens —    Delirium tremens (DTs) is a special form of delirium caused by withdrawal of alcohol from the brain and often accompanied by a coarse tremor, vivid hallucinations, and agitated behavior. It was first described in the Talmud in the fourth and… …   Historical dictionary of Psychiatry

  • delirium\ tremens — [ delirjɔmtremɛ̃s ] ou delirium [ delirjɔm ] n. m. inv. • 1819; en angl. 1813; mots lat. « délire tremblant » ♦ Didact. Délire aigu accompagné d agitation et de tremblement et qui est particulier aux alcooliques. Un accès de delirium tremens. On… …   Encyclopédie Universelle

  • Delirium tremens — Delirium De*lir i*um (d[ e]*l[i^]r [i^]*[u^]m), n. [L., fr. delirare to rave, to wander in mind, prop., to go out of the furrow in plowing; de + lira furrow, track; perh. akin to G. geleise track, rut, and E. last to endure.] 1. (Med.) A state in …   The Collaborative International Dictionary of English

  • delirium tremens — (izg. delírium trȅmens) m DEFINICIJA pat. stanje delirija popraćeno generaliziranim tremorom (drhtanjem), pojačanim znojenjem, bolovima u prsima i probavnim tegobama; oblik akutne alkoholne psihoze u kroničnih alkoholičara uvjetovane sustezanjem… …   Hrvatski jezični portal

  • delírium tremens — sustantivo masculino 1. Área: medicina Delirio con gran agitación y temblor causado por el alcoholismo: Entró en una fase de delírium tremens y daba pena verlo luchando contra sus fantasmas …   Diccionario Salamanca de la Lengua Española

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