Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011206 (delirium)
 5,996 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The occurrence of cerebral seizures in alcoholics was investigated in case histories of 84 delirious and nondelirious male patients. Eighteen patients had seizures before they became alcoholics; the frequency of the seizures increased during abuse. Twelve had no deliria at all up to the moment of this investigation; in 66 of the patients the occurrence of seizures was assumed to be caused by alcohol abuse alone. Seventy-one patients had seizures irrespective of deliria and nearly 40% of them had no deliria at all. In 21% we observed only deliria with seizures; in 16% only deliria without seizures; and 24% had deliria both with and without seizures. The remaining 13 patients of 84 had only deliria complicated by cerebral seizures; only 3 had deliria without seizures. The seizures occurred as grand mal in 94% of the alcoholics, in all patients with genuine epilepsy, and in 60% of the patients with post-traumatic epilepsy.
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PMID:[Cerebral seizures, alcoholism, and deliria (author's transl)]. 12 Jul 31

Withdrawal from alcohol (ethanol, ethyl alcohol) or other general sedatives leads to progressive hyperactivity that progresses from tremulousness, sleep disturbance, and hallucinosis, to the more serious rum fits and delirium tremens (DTs). Withdrawal can be prevented and, in most cases, arrested by prompt replacement of alcohol with paraldehyde, benzodiazepines or other general sedatives. Diazepam is appropriate replacement therapy for most patients. When delirium is manifest, the chance is greater than 15% that the patient will die, and this reaction cannot be aborted. The patient with DTs must be calmed with a general sedative that has a rapid onset of maximal effect to prevent overdosage. Diazepam, 5 mg intravenously every five minutes, permits evaluation of the maximal effect of each dose before the next dose is administered. Although some patients have advance sedative or alcohol withdrawal, great care must be taken to elicit the proper history of alcohol abuse so that sedative replacement therapy will prevent or abort early withdrawal, thus sparing the patient a mortality equivalent to that of acute myocardial infarction or Russian roulette.
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PMID:Management of alcohol withdrawal syndromes. 62 55

371 males admitted to a special hospital for withdrawal treatment of alcoholics were investigated on admission and repeatedly controlled during a follow-up of 3-6 months. In only 15% of all patients without delirium tremens there were no signs of liver disease on admission. 62% showed evidence of moderate or severe liver disease. 2-6 months after admission the percentage with moderate or severe liver disease had decreased (26%) while normal findings were obtained in 49%. On admission no correlation between frequency or degree of liver damage and the duration of alcohol abuse or daily intake of alcohol was demonstrated. Following abstinence of 2 months or more incidence of severe liver changes was nearly unchanged (16%) in patients drinking for more than 20 years, while it dropped distinctly in the groups with shorter duration of abuse (abuse less than 10 years: 5%). Histological alterations were distinctly more frequent in patients with abuse of more than 15 years (pronounced fibrosis 26%, cirrhosis 20%), as compared to alcoholics who drank less than 15 years (5 and 9%, respectively). In the patients with delirium tremens signs of severe liver disease were more frequent than in those without delirium. The trend towards normalisation of liver function tests was less in the former than in the latter (marked pathological findings following 2 months of alcohol abstinence in alcoholics with delirium tremens: duration of alcoholism less than 10 years: 16%; 11-20 years: 33%).
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PMID:[Liver damage in chronic alcoholics with and without delirium tremens (author's transl)]. 127 49

A case of normal pressure hydrocephalus (NTH) complicated by delirious psychosis in the initial phase is described. A history of alcohol abuse made the diagnostic assessment difficult. Normal pressure hydrocephalus (NTH) should be considered in cases of delirium with dementia and histories of disturbances of gait or incontinence of urine.
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PMID:[Hydrocephalus complicated by a delirious condition]. 194 10

This study prospectively evaluated 247 consecutive liver transplantation candidates for the presence of psychiatric disorders. While one-half did not meet DSM-III criteria for a psychiatric diagnosis, 18.6% had delirium, 19.8% had an adjustment disorder, 9% had alcohol abuse or dependence, 4.5% had major depression, and 2% had other drug abuse or dependence. Delirious subjects were significantly more likely to have a lower serum albumin, lower Mini-Mental State exam scores, higher Trailmaking Test scores (both A and B), and more dysrhythmia on electroencephalogram (EEG). In addition, while both delirious and nondelirious subjects were judged to have high levels of overall stress, those with delirium had significantly poorer adaptive functioning and lower occupational, family, and social scale ratings. Thus, while all liver transplant candidates are under substantial psychosocial stress and require psychosocial support, those identified as being delirious require particular attention because of their numerous cognitive, medical, and psychosocial problems.
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PMID:A psychiatric study of 247 liver transplantation candidates. 265 79

Ten (17%) of 58 patients with chronic viral hepatitis treated with a four- to 12-month course of recombinant human interferon alfa developed psychiatric side effects. The psychiatric side effects fell into three categories: an organic personality syndrome characterized by irritability and short temper; an organic affective syndrome marked by extreme emotional lability, depression, and tearfulness; and a delirium marked by clouding of consciousness, agitation, paranoia, and suicidal potential. These psychiatric side effects appeared after one to three months of therapy, usually improved within three to four days of decreasing the dose of interferon alfa, and invariably resolved once therapy was stopped. The organic personality and affective syndromes tended to occur in patients who received the highest dose of interferon alfa, who had relatively mild hepatitis, and who lost weight during interferon treatment. Delirium tended to occur in patients with severe hepatitis who had previous evidence of organic brain injury or dysfunction or previous drug and alcohol abuse. Failure to recognize these side effects quickly and to treat them with supportive therapy and modification of the dose of interferon alfa could result in limitation of therapy and serious personal and interpersonal consequences.
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PMID:Psychiatric complications of long-term interferon alfa therapy. 330 72

Of 200 diagnosed cases of alcoholic delirium 5 (= 2.5%) involved, from the differential diagnostic viewpoint, simulation of alcoholic delirium with all the symptoms involved. The symptoms of the simulation case are compared with the acute symptoms, and points in common to all simulation cases are presented: Definite alcoholic anamnesis, wide experience of treatment for alcohol abuse, dynamics of a pronounced purposeful action when social complications are imminent and course of the symptoms when the interview turns to simulation. In connection with therapy, special attention is drawn to Distraneurin treatment, which is not indicated in such cases.
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PMID:[Simulated alcoholic delirium]. 374 51

Three cases of hallucinatory delirium preceded by prodromal symptoms of several months duration are described. The prodromes were reoccurring visual and tactile hallucinations which were misdiagnosed and ascribed to nonalcohol-related illness such as schizophrenia and disorders of mood.
Am J Drug Alcohol Abuse
PMID:Prodromal syndromes in delirium tremens. 718 3

In a study carried out in 413 alcohol patients, 135 case histories of male delirium patients were evaluated according to clinical-statistical factors. Of importance is the high rate of complications showing 35.9 per cent of delirium patients and a considerable recidivation rate with a remarkable share of second and third deliria. This indicates an excessive alcohol abuse in our service area over many years and makes it possible to draw conclusions with respect to an improvement of prevention, clinical treatment and after-care of the delirium patients.
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PMID:[Several epidemiologic aspects of delirium tremens]. 722 Jun 82

This study was performed to determine preoperative criteria for identifying patients at risk for delirium after major head and neck cancer surgery. The authors prospectively evaluated 138 consecutive patients undergoing head and neck cancer surgery lasting more than 2 hours at the Arthur G. James Cancer Hospital and Research Institute, Ohio State University, Columbus, from July 1993 through May 1994. Postoperative delirium developed in 24 of 138 patients (17%; 95% confidence interval 11% to 24%). The strongest univariate predictors of delirium were living alone (P = .005), the American Society of Anesthesiologists class (P = .003), and the preoperative white blood cell count (P < .0001). A predictive model for delirium using five criteria--age of 70 or more years, alcohol abuse, poor cognitive status, poor functional status, and markedly abnormal serum sodium, potassium, or glucose level--stratified the patients into three cohorts with an increasing risk of postoperative delirium (i.e., 9%, 19%, and 25%).
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PMID:Preoperative identification of patients at risk for delirium after major head and neck cancer surgery. 756 37


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