A 36 yrs old female who is chronic alcoholic feels that she can hear voices commanding her to do thing and has difficulty in falling sleep. Diagnosis is-
Delirium tremens
Depression
Alcoholic hallucinosis
Wernicke's encephalopathy
Ans. is 'c' i.e Alcoholic Hallucinosis Alcoholic hallucinosis is one of the withdrawal syndromes of chronic alcoholism."It is characterized by the presence of hallucinations (usually auditory)* during abstinence, following regular alcohol intake. 'These hallucinations persist after the withdrawal syndrome is over and classically occur in clear consciousness. "other withdrawal syndromesCommonest withdrawal syndrome is - hangover the next morning.Delirium tremensis the most severe alcohol withdrawal syn.it usually occurs within 2-4 days* of complete or significant abstinence from heavy alcohal drinkingthe course is short with recovery occuring within 3-7 days.It is an acute organic brain syndrome characterized by -Clouding of consciousness with disorientation in time and place*Visual (also auditory) hallucinations. *Tactile hallucination of insects crawling over body may occur *Marked autonomic disturbance with tachycardia, fever, sweating, hypertension and pupillary dilatation. *Psychomotor agitation and ataxia*Alcoholic seizures (rum fits)Generalized tonic clonic seizures occur in about 10% of alcohol dependant patients, usually 12-48 hrs after a heavy bout of drinking,Wernicke's encephalopathyis a type of neuropsychiatric complications of chronic alcoholismThis is an acute reaction to severe thiamine deficiency*, the commonest cause being chronic alcohol use.Characterized by the triad of*Global confusion* Ophthalmoplegia* Mnemonic : GOAAtaxia*
Toxicology