No matter how sad it is, in our country a lot of people suffer from alcoholism. There are cases that lead to death. Many of you have probably heard of such a dangerous disease as delirium tremens. What it is? In medicine, this condition is also called metal-alcohol psychosis. It is observed in people who consume large amounts of alcohol over a long period.
Alcoholic delirium is a serious disease that has dangerous symptoms. One of its most characteristic features is hallucinations. In this condition, the patient requires urgent hospitalization and treatment under the supervision of specialists.
Disease Description
What is alcohol delirium? ICD, or the International Classification of Diseases, describes delirium as a mental disorder caused by alcohol abuse. This pathology develops after 7–9 years of regular intake of alcohol. In some cases, delirium is observed in those people who do not suffer from alcoholism. Symptoms of the disease appear after a sharp rejection of alcohol.
Types of disease
Let's look at them in more detail. Alcohol delirium syndrome usually develops in stages. Depending on the type of pathology, a treatment regimen and types of drugs are determined.
Specialists distinguish the following types of disease:
- Classic alcohol delirium: clinical manifestations occur gradually. Pathology goes through several stages.
- Lucid delirium: a disease of this type is characterized by an acute initial stage, delusional state, increased anxiety, coordination disorders, causeless fear, tremor. Hallucinations are usually absent.
- Abortive delirium: accompanied by fragmentary hallucinations, sketchy, poorly formed delusional ideas. A patient in this state has pronounced anxiety. An ailment of this type can easily go into another form of psychosis.
- Professional delirium: the development of psychosis is similar to delirium tremens. Gradually hallucinations and delusions are reduced, in the clinical picture of the disease, the repeated systematic movements associated with the professional activity of a person begin to prevail.
- Mussitic delirium: such a disease can develop after occupational and other forms. Obvious signs are marked clouding of consciousness, motor disorders, somatovegetative disorders.
- Atypical delirium: appears in patients who have previously suffered other forms of the disease.
Causes of the disease
Let's dwell on this aspect in more detail. What can cause delirium tremens? What it is? The main factor in the development of this pathology is alcoholism. Also, the disease may occur due to the use of low-quality alcoholic beverages, such as technical fluids, pharmacological preparations and alcoholic substitutes. Another cause of delirium is traumatic brain injury. However, according to doctors, chronic intoxication of the body and metabolic disturbances in the brain are crucial.
Increases the likelihood of delirium tremens mental or physical stress. Often a disease develops when a patient is injured and enters a hospital. Due to the fact that alcohol ceases to enter the body, withdrawal symptoms develop. A big influence is also exerted by a change of scenery, physical pain and discomfort. A similar situation develops when drunken patients are admitted for treatment to the gastroenterological or cardiology department.
At home, delirium can develop after a sharp exit from binge against the background of exacerbation of somatic disorders.
Symptoms
So what do you need to know about this? What is the diagnosis of alcohol delirium? All signs of the disease are divided into mental and somatic. As a rule, they occur simultaneously, so doctors in 100% of cases make the correct diagnosis. The most striking symptom is hallucinations. The patient may see fantastic creatures, animals or insects. Some people think that someone is crawling over their bodies. The main danger of this condition is that the patient can injure himself due to false sensations.
Alcoholic psychosis also has physiological characteristics. These include:
- heavy sweating;
- hand tremor;
- facial redness;
- Heart rate over 100 beats;
- high blood pressure;
- dyspnea;
- vomiting
- heat;
- headache;
- cramps.
Simultaneously with physiological symptoms, mental ones appear. This group of symptoms is associated with brain damage. These include:
- panic feeling of fear;
- rave;
- insomnia;
- nightmares;
- visual;
- tactile and auditory hallucinations;
- excessive agitation;
- disorientation in space and time.
Stages
So what are they like? Alcoholic delirium (delirium tremens) has several stages of development. Each of them has its own characteristic features. Therapy is usually prescribed taking into account the patient's condition. Therefore, correct diagnosis at the initial stage is extremely important.
Consider in more detail the description of each of the stages:
- Initial. It is characterized by disturbances in the emotional state of a person. It changes very quickly. Instead of anxiety and anxiety comes euphoria. Also, depression and despondency can suddenly come. The speech and facial expressions of the patient remain alive. It may seem to an outside observer that the person is just a little worried. Any stimuli can cause an acute reaction, be it sharp sounds, smells or flashes of light. The patient can talk about vivid images and memories that arise in his mind. Fragmentary visual and auditory hallucinations are also noted. The patient often wakes up at night and feels a pronounced anxiety.
- The appearance of hallucinations. At this stage, alcohol delirium (according to ICD-10, it is assigned the code F10.4) can already be clearly diagnosed. All symptoms of the disease become more pronounced. Signs of psychosis such as visual, auditory, gustatory and tactile hallucinations are noted. Visual delirium manifests itself in the form of insects attacking the patient. In some cases, patients see images of deceased relatives. Simultaneously with this symptom, a sharp increase in body temperature, blood pressure and heart rate is usually observed. In the presence of concomitant pathologies, such as severe trauma, depression or previous delirium, the second stage progresses and becomes the third.
- True hallucinatory alcohol delirium. Assistance to the patient at this stage of the disease can only be provided in inpatient settings. Therapy includes medical and physiotherapeutic methods. At the stage of true delirium, the patient ceases to adequately respond to external stimuli, his speech becomes quiet and incoherent. Blood pressure drops dramatically, convulsions, tremors, shortness of breath can begin. In severe cases, the patient may even fall into a coma. Sometimes, with severe cerebral edema, a fatal outcome is possible. In many internal organs, irreversible destructive processes occur.
How to independently recognize alcohol delirium (according to ICD-10, F10.4)? The main sign of intoxication is an epileptic seizure. It can occur both after drinking alcohol, and with a sharp rejection of it. The patient also has difficulty breathing, hoarseness, blueness of the area around the mouth and nose, loss of consciousness, rolling eyes, the appearance of foam from the mouth, vomiting, unnatural postures. When the patient comes to his senses, he behaves extremely harshly and aggressively. Impaired vision, memory, and hearing may also occur.
Treatment
Where to start in the first place? Now that you know about a disease such as alcohol delirium, what it is, as well as its main symptoms, you can start talking about treatment. In this condition, the patient requires intensive drug therapy and quality care. In some cases, resuscitation is necessary. Treatment of delirium is usually carried out on the basis of a neuropsychiatric hospital. The condition of the patient should be observed by a therapist and resuscitator. Prescribed methods and drugs may vary depending on the clinical picture of the disease.
Relief of symptoms
What it is? How to treat alcohol delirium (code according to ICD-10, F10.4)? When signs of the disease, such as hallucinations, appear, you must immediately call an ambulance. The patient will be referred for treatment to a narcological or psychiatric dispensary, where he will be able to receive the necessary care. Before the ambulance arrives, try to put the patient to bed. Do not leave the patient unattended, as in this condition he can injure himself or others. In a medical facility, patient safety can be ensured by staff.
To stop pronounced symptoms, doctors usually use the following methods:
- Deep sedation: the patient is connected to the ventilator until the completion of delirium attacks.
- Cupping with medications. In this case, the patient remains on spontaneous breathing.
Drug treatment
What is it like? What drugs will be effective in treating a disease such as alcohol delirium? ICD classifies the disease as quite severe, therefore self-medication in this case is unacceptable. An experienced doctor will help you find the list of necessary drugs. With the wrong treatment regimen, complications may appear.
In medical institutions for the treatment of delirium, the following groups of drugs are used:
- psychotropic drugs;
- means that ensure the normal functioning of the respiratory system;
- preparations for maintaining water-salt balance;
- means for adjusting blood pressure;
- medications for insomnia;
- drugs that normalize metabolism;
- detoxification agents;
- drugs that improve the work of the cardiovascular system.
Detoxification
This aspect should be given special significance. One of the essential stages of the fight against the disease is detoxification of the body. It is necessary to clean the blood and internal organs of the patient from poisons. Often, against the background of alcoholism, patients develop heart failure, disorders in the digestive tract, kidneys and liver. The most effective is the intravenous administration of drugs such as Unitol or Piracetam.
Plasmapheresis is another effective way to cleanse the blood with a disease such as alcohol delirium (code, according to ICD 10, F10.4). With this method, part of the patient’s plasma is replaced with a special solution. This helps to achieve maximum cleansing effect. The cells of the body are released from poisons, which lead to the development of withdrawal symptoms.
The advantages of plasmapheresis are as follows:
- metabolic processes in the brain are normalized;
- rheological characteristics of the blood improve;
- the immune system is restored;
- the duration of therapy is significantly reduced.
After plasmapheresis, the patient, as a rule, feels relief. An additional positive effect can be achieved by taking diuretic drugs. An important part of detoxification therapy is taking medications that are responsible for the restoration of liver cells.
Sleep normalization
How to restore the functioning of the body after a disease such as alcohol delirium (according to ICD-10, F10.4)? One of the most important steps is to stimulate sleep. Typically, benzodiazepines are used for these purposes. These drugs are officially recognized as the safest at any stage of alcoholism. The dosage is determined by the doctor. Medicines should stop the main signs of alcoholic psychosis, but they should not inhibit spontaneous breathing.
If necessary, drugs can enter the patient into a state of prolonged sleep. The safest drugs are Diazepam and Phenazepam. If the patient is diagnosed with a malfunction in the liver, he is recommended to use "Lorazepam". Drugs in this group will avoid the development of a state of increased nervous excitability.
Alcoholic delirium (code according to ICD-10, F10.4) may be accompanied by increased aggression. To combat such symptoms, antipsychotics are used. In modern medicine, the use of such drugs is an additional measure if benzodiazepines do not bring the desired effect. Antipsychotics can lead to serious side effects. They lower the seizure threshold and cause hypotension.
Healing therapy
What is its feature? Alcoholic delirium (10 ICD, F10.4) is a serious disease that can inhibit the activity of various body systems. A mandatory component of treatment is the restoration of the functions of the cardiovascular, autonomic, endocrine and nervous systems. To get rid of the withdrawal symptom, it is necessary to establish blood flow. Synthetic or herbal medicines may be used to improve cardiac performance. Normalization of blood circulation will lead to the restoration of metabolic processes, memory, hearing and neural connections.
To resume the internal forces of the body, doctors usually prescribe vitamin complexes and special medicines to cleanse the blood of alcohol decay products. At the recovery stage, folk methods can be used. To decorate blood vessels and improve blood circulation, decoctions from herbs are good.
Conclusion
In this review, we examined in detail a disease called alcohol delirium: what it is and how to deal with it. This is a rather serious pathology, which requires serious treatment in a medical institution. If you do not turn to specialists in time, the disease can cause serious complications.