[New aspects of the pathogenesis and therapy of alcoholic delirium (author's transl)].
Clinically, and especially biochemically, alcoholic delirium corresponds closely to an incipient but reversible exogenous hepatic coma. The blood levels of ammonia in particular, free phenols and lactate are greatly increased. These same metabolites increase slightly in the blood of persons with healthy livers after a single alcohol loading. The treatment of alcoholic delirium consists of optimal sedation with Distraneurin, which appears to have no side effects on the liver. There is even a lowering of the raised lactate level in the blood after a single administration of Distraneurin. Ammonia and phenols are reduced by ammonia-lowering aminoacids, lactulose and bifidum milk. Most important, however, is strict abstention from alcohol, which alone brings about a rapid improvement of pathological biochemical and morphological liver findings.
D000430:Alcohol Withdrawal Delirium / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D000437:Alcoholism / Q000097:blood / Q000150:complications; D000641:Ammonia / Q000097:blood; D002719:Chlormethiazole / Q000008:administration & dosage; D005234:Fatty Liver / Q000209:etiology; D006501:Hepatic Encephalopathy / Q000097:blood; D006801:Humans; D007200:Indican / Q000097:blood; D007773:Lactates / Q000097:blood; D008103:Liver Cirrhosis / Q000209:etiology; D010636:Phenols / Q000097:blood; D011604:Psychoses, Alcoholic / Q000209:etiology*
D007773:Lactates; D010636:Phenols; D002719:Chlormethiazole; D000641:Ammonia; D007200:Indican
Neue Gesichtspunkte zur Pathogenese und Therapie des Alkoholdelirs