Articles: alcohol-withdrawal-delirium.
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The outcome in 165 subjects with either an unknown (n = 93) or an alcohol-related (n = 72) seizure etiology, admitted to the emergency room of a general hospital in 1977-1978, was assessed after 10 years on the basis of subsequent hospital records and death-certificate-based mortality data. Alcohol and/or drug poisoning was the most frequent cause of death in the group with alcohol-related seizures. Sixty-four percent of the deaths in this group were directly related to alcohol abuse. ⋯ We conclude that alcohol abuse is an important, though often undetected, seizure etiology carrying a poor prognosis. The difference in mortality between the groups was due more to alcoholism than to seizures. There was no difference in mortality between those with a first alcohol-related seizure and those with previous alcohol-related seizures.
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J Clin Psychopharmacol · Oct 1991
Comparative StudyBenzodiazepine requirements during alcohol withdrawal syndrome: clinical implications of using a standardized withdrawal scale.
An accurate characterization of the severity of the alcohol withdrawal syndrome is likely to provide clear guidelines for drug therapy in this disorder. We studied (retrospectively) the usefulness of a standardized withdrawal scale on benzodiazepine drug requirements for patients undergoing alcohol detoxification in a general hospital. One hundred thirty-three patients received the revised Clinical Institute withdrawal Assessment Scale for Alcohol and were medicated only if the score was greater than 10. ⋯ Rank correlation coefficients revealed a closer relationship between the degree of alcohol exposure (as determined by admitting blood alcohol levels, creatine phosphokinase, and SGOT) and benzodiazepine requirements during withdrawal for the group treated with the scale. Findings suggest that when the scale is used, patients with a greater degree of physical dependence receive (appropriately) a higher dose of benzodiazepine and those with a lesser degree of dependence receive (appropriately) a lower dose of benzodiazepine. Use of the scale appears to minimize both under- and overdosing with benzodiazepine for alcohol withdrawal syndrome.
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Psychiatr Neurol Med Psychol (Leipz) · Dec 1989
[Electrolyte disorders, EEG changes and epileptic seizures in alcohol withdrawal delirium].
For 180 patients suffering alcohol-withdrawal induced delirium, electrolytic concentration in the serum of Na, K, Ca, and Mg was determined in the early withdrawal phase, and the electroencephalograms of 95 delirium patients evaluated in respect of local and diffuse changes and epileptic activity, and compared in delirium patients with and without initial seizures. Delirium patients who had initial seizures suffered significantly longer-lasting periods of delirium and significantly more frequent electrolytic changes in the form of hypomagnesemia and hypopotassemia (hypokalemia). There was no significant difference in the EEG changes. A temporary metabolic disorder in the initial phase of the two-phase withdrawal process should be assumed to be the cause of seizures during alcohol withdrawal, and the pathogenetic significance of hypomagnesemia and hypopotassemia should be taken into consideration.
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A shortened 10-item scale for clinical quantitation of the severity of the alcohol withdrawal syndrome has been developed. This scale offers an increase in efficiency while at the same time retaining clinical usefulness, validity and reliability. It can be incorporated into the usual clinical care of patients undergoing alcohol withdrawal and into clinical drug trials of alcohol withdrawal.