alcohol-naïve volunteers given continual alcohol for longer periods developed more severe withdrawal than those who drank for shorter periods
Symptoms are usually present within six hours of the cessation of drinking and often develop while patients still have a significant blood alcohol concentration
If withdrawal does not progress, these findings resolve within 24 to 48 hours.
Withdrawal-associated seizures are generalized tonic-clonic convulsions that usually occur within 12 to 48 hours after the last alcoholic drink
typical onset during the fourth and fifth decades of life.
Benzodiazepines, phenobarbital, and propofol are recommended in that order to treat status epilepticus
phenytoin is ineffective in the treatment of alcohol withdrawal seizures
alcohol withdrawal seizures left untreated progress to delirium tremens (DT) in nearly one-third of patients
Alcoholic hallucinosis refers to hallucinations that develop within 12 to 24 hours of abstinence and typically resolve within 24 to 48 hours
Patients are aware that they are hallucinating
often very distressed
is not associated with global clouding of the sensorium, but only with specific hallucinations, and vital signs are usually normal.
5 percent of patients who undergo withdrawal from alcohol suffer from DT
hallucinations, disorientation, tachycardia, hypertension, hyperthermia, agitation, and diaphoresis
begins between 48 and 96 hours after the last drink and lasts one to five days
Virtually all patients who develop DT experience some symptoms of minor alcohol withdrawal prior to the onset of DT
elevated cardiac indices, oxygen delivery, and oxygen consumption
Arterial pH rises due to hyperventilation
Hyperventilation and consequent respiratory alkalosis in this setting result in a significant decrease in cerebral blood flow
correlation between the length of the preceding alcohol binge, the degree of clouding of the sensorium, and the size of the average decrease in cerebral hemispheric blood flow
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