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Delirium tremens (DT’s) is a more severe alcohol withdrawal syndrome seen after excessive prolonged alcohol use. Prior episodes of DT’s or co morbid medical illness are risk factors for poor outcome. DT’s require rapid and robust medical intervention since, untreated, it can be fatal in up to 20% of cases but if treated this can be reduced to less than 1%.
Diagnostic criteria alcohol withdrawal delirium include:
A. Disturbance of consciousness with reduced ability to focus, sustain, or shift attention (impaired awareness of person, place and time).
B. A change in cognition or the development of a perceptual disturbance.
C. The disturbance develops over a short period of time and tends to fluctuate during the day.
D. The disturbance developed after alcohol withdrawal (from history, physical exam or laboratory findings)
E. Other medical causes of delirium need to be ruled out.
