A patient is known alcoholic since last 20 yrs, suddenly he develops restless tremors, agitation. Diagnosis ?
**Core Concept**
Delirium tremens is a severe form of alcohol withdrawal characterized by sudden onset of tremors, agitation, hallucinations, and altered mental status. It occurs typically 48-96 hours after the last drink in individuals with a long history of heavy alcohol use.
**Why the Correct Answer is Right**
The development of delirium tremens is thought to be due to the sudden withdrawal of alcohol, leading to a surge in the activity of excitatory neurotransmitters such as glutamate and an imbalance of the GABA-glutamate neurotransmitter system. This imbalance causes an increase in the activity of the sympathetic nervous system, leading to symptoms such as tremors, agitation, and hallucinations. The patient's long history of heavy alcohol use has likely led to adaptations in the brain, making it more susceptible to withdrawal.
**Why Each Wrong Option is Incorrect**
**Option A:** While anxiety and tremors can be symptoms of alcohol withdrawal, they do not fully capture the severity and complexity of delirium tremens.
**Option B:** While agitation is a symptom of delirium tremens, it is not a specific enough diagnosis to be correct.
**Option C:** Delirium tremens is not a form of depression, although mood disturbances can occur in alcohol withdrawal.
**Clinical Pearl / High-Yield Fact**
Delirium tremens is a medical emergency that requires prompt treatment with benzodiazepines, such as lorazepam or diazepam, to manage symptoms and prevent complications.
**Correct Answer:** D. Delirium tremens