The Latin word delirium is translated as "insanity", "dementia." Ethanol, which is found in alcohol and naturally enters the human body, is a powerful neurotoxin that affects human brain cells. This leads to the formation of delirium. In the people it carries the name "delirium tremens".
Causes of occurrence
This disease belongs to the category of psychoses. The main reason for alcohol delirium is the refusal to drink alcohol after prolonged libations by people suffering from stage II-III alcoholism. Also, the cause may be the use of an alcoholic substitute.
In the stage of intoxication with alcohol, a mental disorder does not affect the psyche, but by 2-4 days its symptoms may be felt. An organism accustomed to the presence of alcohol reacts sharply to its absence. This factor triggers the disease process.
Forms
In accordance with the international classification (ICD-10), the following types of alcoholic delirium are distinguished:
- Professional.
- Mussitating (muttering).
The latter type of disorder is quite dangerous. In it, the patient is in bed, makes strange sounds, and also makes movements that simulate wrapping, stroking. The danger of this condition is that it is fraught with death. As for the professional type, its main characteristic is as follows: being in a state of insanity, the patient imitates his ordinary labor 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 after 40 years who regularly drink alcohol for 5-7 years. In women, this disease progresses much faster. The following groups of persons are most affected by it:
- Women and men who already had an episode of alcohol delirium (delirium tremens).
- Chronic alcoholics with an experience of more than 5 years.
- Persons who have suffered a head injury in the past.
- Those who have chronic infections in the acute stage.
Establishing 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 alcoholic delirium is preceded by certain circumstances that forced to suddenly refuse to take large doses of alcohol. The first signs of the disease can occur long before the onset of psychosis. It could be:
- Vomiting
- Headache.
- Speech Disorders.
- Cramps.
Before the end of binge, deterioration in physical well-being may be noted. Appetite is reduced, often an aversion to food is manifested. In the morning hours, nausea can occur, which ends in vomiting. The patient may complain of a feeling of pain and heaviness in the stomach. Dizziness intensifies. Chills can be replaced by a feeling of heat. Symptoms such as numbness in the legs, heart pain, and cramps can also occur. Sometimes suffering from delirium tremens seek to alleviate their condition by taking small doses of alcohol, procuring them for the night. Often, a single dosage is reduced, since the patient feels himself more and more physically weak.
Over time, other signs that belong to the group of somatic manifestations may appear.
- The skin of the face takes on a reddish tint.
- Increased blood pressure, as well as body temperature.
- Heartbeat becomes more frequent.
- Tremor in the hands, increased sweating.
Disease development
After the binge is stopped, withdrawal symptoms are particularly severe symptoms. Repeated vomiting, a feeling of suffocation in the region of the heart may occur, and fear of death arises. Patients practically cannot fall asleep. 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 shade of the sclera is found. Pulse and breathing quicker. The tongue is covered with plaque. Feeling sick is reflected in the suffering facial expressions.
Against the background of an anxious mood, irritability and aggressiveness increase. Changes in the psyche also indicate the approaching alcohol delirium. The condition is characterized by motor inhibition, efficiency, fussiness. Depressive affect is combined with gloomy hypochondria, resentment, viciousness. Sometimes he is replaced by a tendency to fleeting humorous utterances. Unstable ideas of paranoia, witchcraft, jealousy may arise. Bright memories come from the past.
If the patient falls asleep, his dreams are distinguished by anxiety and fantasticness. Upon awakening, he can not always draw a line between the real situation and what he dreamed.
Sleep also gets worse, unexplained anxiety arises. As alcohol delirium develops, the symptoms become more and more psychotic. The most acute symptoms of the disease begin to appear 3-4 days after the start. It:
- Hallucinations.
- Insomnia.
- Nervous agitation.
Types of Hallucinations
The nature of the manifestation of scary visions is quite individual. They are conditionally divided into the following groups:
- Visual.
- Tactile.
- Voices in the head (auditory).
- Rave.
Suffering from delirium tremens begin to jump up, mumble something, suspiciously inspect the room in which they are located. They have abundant illusions. Their intensity decreases with a decrease in the concentration of attention on them or with distraction. The condition is constantly fluctuating. Sometimes people suffering from delirium tremens syndrome understand that something is wrong with them. However, such periods are short-lived, neurological symptoms are unstable and precede hallucinatory stupor. Patients may see various fantastic creatures: rats, devils, gnomes, insects, monsters. The imaginary creatures seem to the alcoholic active, constantly acting on the nerves, causing fear or aggression.
Debut
In about one third of all cases, alcohol delirium, which occurs for the first time, is accompanied by verbal hallucinations. They determine the condition of the patient for several hours. Often verbal deceptions become quite extensive, systematized. There are ideas of persecution, observation, physical impact. Often, alcoholics do not say anything about the contents of delirium due to its offensive content, which can affect the most intimate aspects of life. Hallucination is accompanied by significant changes in perception, consciousness. This is evidenced by subsequent amnesia of experiences.
Often, what is heard by an alcoholic is perceived so real that he uses the word “saw” rather than “heard” to describe, for example, scenes of executions of people. Often the content of the voices is fantastic. The patient's behavior is characterized by insufficient motivation, the desire to fulfill hallucinatory "orders." This is the manifestation of delirious coloration of the disease. The depth of confusion can be so serious that patients amnesize for long periods of time during which they made comments to someone, sharply gestured, sought 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 a "squirrel" - if you have symptoms, you should consult a doctor. The use of unconventional methods of treatment can turn into a fatal outcome. Patients need emergency hospitalization.
With a diagnosis of "alcohol delirium," the patient ends up in a drug treatment facility or in the psychiatric ward of the hospital.
In this case, only medical therapy is used, which implies the removal of toxins from the body and the introduction into deep sleep. Rest can significantly accelerate recovery and restore clarity of consciousness. After carrying out measures of drug therapy, the patient may feel weakness and memory lapses. Sometimes he can remember his hallucinations quite clearly, but completely forget the real events. Treatment of alcoholic delirium is carried out only inpatiently, under the strict supervision of a narcologist. Sometimes the help of a therapist may be appropriate.
Help with alcohol delirium
What to do if a person is in a state of delirium tremens, and the ambulance has not arrived yet? The first thing that can be done is to put the patient in bed, to 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 fluid as possible. Then you must immediately call an ambulance. Do not do anything else before the doctors arrive.
Inpatient therapy
When a patient enters a medical facility, the doctor may prescribe one of the following drugs:
- Diphenhydramine;
- Barbamil
- Diazepam
- "Sodium oxybutyrate."
In addition, vitamins are often used for treatment, as well as medications to restore internal organs damaged during the delirium tremens.
Complications
As practice shows, the consequences of alcohol delirium cannot be avoided - especially if treatment attempts are made at home. The worst consequence of delirium is death. In other cases, the following are possible:
- Disturbances in the central nervous system, in particular the brain.
- Acute renal failure.
- Mental disorders.
- Decreased hearing and vision.
- Weakened immunity.
Also, after the delirium tremens, such terrible situations as chronic delirium or coma can occur.
The lethal outcome from this disease is from 5 to 10% of the total number of cases. In most cases, cerebral edema or cardiac arrest occurs. Death can also occur due to:
- Suicide under the influence of hallucinatory delirium.
- Accident - not realizing their actions, a person may fall under the wheels of a car or fall out of a window.
- Pulmonary edema.
- Respiratory arrest.
Korsakovsky syndrome
Another serious complication that is caused by delirium. Typically, this type of psychosis develops in the late stages of fever. Korsakovsky syndrome manifests itself in the fact that the patient does not remember relatives, does not recognize friends. 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. In such cases paralysis is frequent, complete loss of working capacity.
In the presence of Korsakovsky psychosis, an alcoholic receives disability. The working capacity of such people is already impossible to restore. 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 personality degradation. Just a couple of attacks of delirium are enough to make this process irreversible - after all, when exposed to alcohol, neurons are destroyed in large quantities.
Delirium tremens is a rather serious disease. When its first symptoms occur, in no case should you hesitate. After all, too late an ambulance call can cost an alcoholic life.