[Diagnostics and therapy of alcohol withdrawal syndrome: focus on delirium tremens and withdrawal seizure].
BACKGROUND
Delirium tremens and withdrawal seizures are serious complications of an alcohol withdrawal syndrome. This review presents the diagnostic procedures required in case of the occurrence of a withdrawal seizure and delirium tremens as well as possible treatment options including prophylactic medication regimen for alcohol withdrawal syndrome. Furthermore non-pharmacological procedures accompanying delirium tremens and a potential integration of viewing videotapes of delirium tremens in the course of alcohol-specific therapy are discussed.


METHODS
A systematic literature research using Pubmed has been carried out to find recent studies and review articles dealing with alcohol withdrawal syndrome.


CONCLUSIONS
Regarding the diagnostic algorithm in case of the occurrence of a withdrawal seizure or a delirium tremens basic diagnostic procedures and special diagnostics including neuro-imaging or cerebrospinal fluid puncture depending on patients' clinical condition have to be considered. Sedatives are important in treatment of alcohol withdrawal seizures and delirium tremens as well as in the prophylaxis of alcohol withdrawal syndrome. A long-lasting prescription of anticonvulsant medication in patients suffering from withdrawal seizure should be considered critically and can be carried out only under certain conditions.
Lutz
Ulrich C
UC
Universitätsklinik für Psychiatrie und Psychotherapie, Sektion für Suchtmedizin und Suchtforschung, Tübingen, Germany. Ulrich.Lutz@med.uni-tuebingen.de
Batra
Anil
A
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D000430:Alcohol Withdrawal Delirium / Q000145:classification / Q000175:diagnosis* / Q000517:prevention & control / Q000534:rehabilitation*; D020270:Alcohol Withdrawal Seizures / Q000145:classification / Q000175:diagnosis* / Q000517:prevention & control / Q000534:rehabilitation*; D000437:Alcoholism / Q000534:rehabilitation*; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D002707:Chlordiazepoxide / Q000008:administration & dosage / Q000009:adverse effects; D002719:Chlormethiazole / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D015897:Comorbidity; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D004347:Drug Interactions; D000431:Ethanol / Q000097:blood / Q000633:toxicity; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D055502:Secondary Prevention
D000319:Adrenergic beta-Antagonists; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D002719:Chlormethiazole; D001569:Benzodiazepines; D000431:Ethanol; D002707:Chlordiazepoxide