Alcoholic Delirium and Other Withdrawal Syndromes

Alcoholism is a major public health problem causing various neurological diseases (Table 1), the most frequent and most important of them being delirium tremens (DT). In our experience, more than 20% of 1720 patients admitted to the neurological intensive care unit (ICU) during a 7-year period were alcohol dependent. Of these, 78 admissions (4.5%) were because of delirium tremens. Three distinct scenarios associated with alcoholism are frequently encountered in the neurological ICU: 1. A known alcoholic is admitted because of an illness not directly caused by alcohol; prophylactic treatment to avoid DT is required. 2. An alcoholic is admitted with clear signs of alcohol withdrawal (impending delirium tremens); development of full-blown delirium tremens must be prevented. 3. A patient is admitted specifically because of active delirium tremens or has developed DT while being treated for another disease.