1/33. Acute myocardical infarction due to delirium tremens.A 36-year-old patient with normal-appearing coronary arteries suffered an acute Q-wave myocardial infarction during acute alcohol withdrawal and delirium tremens. Sympathetic hyperactivity with coronary spasm and increased platelet reactivity are probably the underlying mechanisms.- - - - - - - - - - ranking = 1keywords = delirium (Clic here for more details about this article) |
2/33. Refractory delirium tremens treated with propofol: a case series.Delirium tremens, the most serious manifestation of alcohol withdrawal, occurs in approximately 5% of hospitalized alcoholics and has a mortality rate approaching 15%. patients with delirium tremens are usually treated in an intensive care unit in which benzodiazepines form the cornerstone of therapy. In this report, we describe four patients who proved refractory to high doses of benzodiazepines and were successfully treated with a propofol infusion.- - - - - - - - - - ranking = 1keywords = delirium (Clic here for more details about this article) |
3/33. Delirium tremens in a nine-year-old child.The authors report a case of delirium tremens in a 9-year-old American Indian boy, who was later found to have been drinking steadily for 3 years prior to his emergency admission for agitation and delirium. The authors suggest that the use of alcohol by children is an activity that may be more common than most physicians realize.- - - - - - - - - - ranking = 0.4keywords = delirium (Clic here for more details about this article) |
4/33. Delirium in the intensive care unit: are we helping the patient?The intensive care unit (ICU) represents a dynamic interaction between patient factors and interventional factors. The complexity of this situation can generate an impaired consciousness in the patients. The critical care provider is faced with deducing the etiology and treatment of delirium in the ICU. Many of the therapeutic agents that are used in the ICU may precipitate delirium. patients may also experience delirium as part of their underlying medical conditions. Withdrawal syndromes, delirium tremens in particular, are known to cause delirium. By a combination of appropriate selection of medications and an awareness of delirium as a side effect, the patient in the ICU may be treated in a manner to minimize the clouding of consciousness. An understanding of the proposed pathophysiology of various types of delirium will allow appropriate clinical measures to be taken.- - - - - - - - - - ranking = 1.4keywords = delirium (Clic here for more details about this article) |
5/33. cannabis-related acute brain syndrome following major trauma.An acute brain syndrome in a cannabis-dependent patient, who sustained multiple injuries, is described. Points of difference between this syndrome and delirium tremens are discussed. Recommendations are made regarding the treatment of this complication, which may follow multiple injuries or operative procedures.- - - - - - - - - - ranking = 0.2keywords = delirium (Clic here for more details about this article) |
6/33. Suppression of alcohol delirium tremens by baclofen administration: a case report.Delirium tremens (DT) is a clinical condition that appears in some patients affected by severe alcohol withdrawal syndrome (AWS). DT represents a serious complication, being characterized by elevated morbidity and mortality. benzodiazepines are presently the drug of choice; however their use is related to several side effects. baclofen is a stereoselective gamma-aminobutyric acid (GABAB) receptor agonist. Recent studies show that baclofen is able to suppress alcohol withdrawal symptoms. At present there are no data on the effects of baclofen administration in AWS complicated by DT. Here, we report a case of DT successfully treated with baclofen. This result indicates that the efficacy of baclofen in the treatment of DT should be examined in future clinical trials.- - - - - - - - - - ranking = 0.8keywords = delirium (Clic here for more details about this article) |
7/33. Alcohol withdrawal as an underrated cause of agitated delirium and terminal restlessness in patients with advanced malignancy.A significant number of patients with terminal cancer experience terminal restlessness or an agitated delirium in the final days of life. Multifactorial etiologies may contribute to agitation and restlessness for any one patient; alcohol withdrawal may be underrated as a contributing factor. The symptoms and signs of alcohol withdrawal--autonomic dysfunction, tremor, anxiety, sleep disturbances, insomnia, and abnormal vital signs--may continue for 6 to 12 months after the cessation of alcohol. We report four patients with terminal restlessness in whom we believe alcohol withdrawal to be a significant causal factor and a fifth patient who subsequently benefited from our team's increased awareness of this clinical problem. Formal assessment of alcohol withdrawal may be of more value in the palliative setting than using the currently accepted assessment instruments. Many of the medications utilized for the treatment of agitated delirium and terminal restlessness in the palliative care setting are effective therapies for alcohol withdrawal.- - - - - - - - - - ranking = 1.2keywords = delirium (Clic here for more details about this article) |
8/33. Case of prolonged alcohol withdrawal syndrome accompanied with hyperthyroidsim.hyperthyroidism is associated with increased psychiatric morbidity. It may alter the clinical course of alcohol withdrawal syndrome. We report a 69 year old man who presented prolonged alcohol withdrawal syndrome associated with hyperthyroidism. Initially, he developed typical alcohol withdrawal syndrome including tremor, disorientation, delirium and visual hallucination of small animals. thyroid function tests revealed a free triiodothyronine (T3) of 6.1 pg/dl (range, 3.0 to 5.8), a free thyroxine (T4) of 2.3 ng/dl (range, 0.85 to 2.15) and a thyroid stimulating hormone (TSH) of 0.003 microU/ml (range, 0.3 to 4.0), and thiamazole was administered. Even after a month, he continuously presented persecutory delusion, auditory hallucination and cognitive dysfunction. Although these symptoms did not respond to the medication including antipsychotics, they totally passed away after the thyroid function reached down to the normal level (free T3 3.0 pg/ml, free T4 1.1 ng/dl, TSH 0.004 microU/ml). In addition, cognitive function was recovered to the normal level as he scored 28/30 on the Mini Mental State Examination. We propose that hyperthyroidism contributed to the occurrence of psychotic symptoms and cognitive dysfunction.- - - - - - - - - - ranking = 0.2keywords = delirium (Clic here for more details about this article) |
9/33. Adjunctive valproic acid for delirium and/or agitation on a consultation-liaison service: a report of six cases.The authors present six cases in which valproate was used in patients seen by a consultation-liaison service (CLS) to manage delirium and/or psychotic agitation. The intravenous (IV) preparation (Depacon, Abbott laboratories) was used in two nothing by mouth (NPO) patients, while the liquid oral preparation (Depakene, Abbott laboratories) was used via nasogastric tube (NGT) in the other patients. All of these cases had suboptimal responses and/or concerning side effects from conventional therapy with benzodiazepines and/or antipsychotics. In all six cases, the CLS use of valproic acid combined with conventional antidelirium medications resulted in improved control of behavioral symptoms without significant side effects from valproic acid. Consultation-liaison psychiatrists should consider the addition of valproic acid to control behavioral symptoms of delirium when conventional therapy is inadequate. This may be especially advisable when problematic side effects result from more conventional psychopharmacological management. Specifically, intravenous valproate sodium may be a viable option for NPO patients.- - - - - - - - - - ranking = 1.4keywords = delirium (Clic here for more details about this article) |
10/33. dexmedetomidine as an adjuvant in the treatment of alcohol withdrawal delirium: a case report.In this case report, even a moderate dose of dexmedetomidine, a very selective alpha(2)-adrenergic agent, resulted in a rapid response to alcohol withdrawal delirium after the standard treatment. Psychiatrists should be aware of this relatively new drug that provides advantages over clonidine, heavy sedation and secondary restraints. dexmedetomidine should be further evaluated in the treatment of specific forms of aggressive behavior and complicated withdrawal states.- - - - - - - - - - ranking = 1keywords = delirium (Clic here for more details about this article) |
| | Next -> |