A patient avoided drinking alcohol for 3 days.The patient is a known alcoholic since last 20 yrs.Suddenly he develops restless tremors, agitation. Diagnosis -

Ans. is 'a' i.e., Delirium tremens [Ref: Neeraj Ahuja 6th/ep. 41\ Delirium tremens o Delirium tremens is the most severe alcohol withdrawal syndrome. It occurs usually within 2-4 days of complete or significant alcohol abstinence. This is an acute organic brain syndrome (delirium) with characteristic features of delirium. Clouding of consciousness with disorientation in time and place. Poor attention span and distractibility. Visual (and also auditory) hallucination, and illusion. A tactile hallucination of insect crawling under the skin (formication) may also occur. Marked autonomic disturbances with tachycardia, sweating, hypertension, mydriasis, coarse tremors. Insomnia, psychomotor agitation, ataxia, anxiety. o Benzodiazepines are the drugs of choice for delirium tremens. Chlordiazepoxide is the agent of choice with diazepam as an alternative.