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EMI – mixed topics
Published in Bhaskar Punukollu, Michael Phelan, Anish Unadkat, MRCPsych Part 1 In a Box, 2019
Bhaskar Punukollu, Michael Phelan, Anish Unadkat
1. B, D. Alcohol withdrawal and depression: Alcohol withdrawal – (i) Usually begins 12–48 hours after cessation of drinking, (ii) Common symptoms include tremor, weakness, sweating, and nausea, (iii) Seizures occur less commonly. Alcoholic hallucinosis – (i) Follows a period of abstinence after heavy chronic drinking, (ii) Characterized by auditory hallucinations usually persecutory or threatening in nature, (iii) Symptoms may last for days and can be controlled with antipsychotic drugs such as chlorpromazine.
Psychiatry
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
alcoholic hallucinosis: rare conditions in which auditory hallucinations occur alone in clear consciousnessusually clears in a few days, but may be followed by secondary delusional misinterpretationup to 50% go on to develop symptoms of schizophrenia (Benedetti, 1952)
Intoxicants
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
A diagnosis of “alcohol withdrawal” as defined by the Diagnostic and Statistical Manual of Mental Disorders–5 (APA, 2013) must include the criteria listed in Table 68.1 with clinical symptoms appearing anywhere from hours to days after a decrease or cessation in alcohol intake. Sudden abstinence in the setting of chronic alcohol consumption increases the possibility of developing withdrawal seizures, alcoholic hallucinosis, and delirium tremens. Withdrawal seizures occur in approximately 10% of patients and generally appear within 12–48 hours after decreased alcohol intake (Sarff and Gold, 2010, p. S495). Typically, seizures are not sustained status epilepticus, but rather brief tonic-clonic seizures. However, up to 60% of patients have multiple seizures with a previous history of withdrawal-related seizures being a significant risk factor for the development of seizures in future withdrawal episodes (Sarff and Gold, 2010, p. S495). Not all seizures occurring during an episode of alcohol withdrawal are related to the withdrawal itself; approximately 50% of seizures are a result of a separate physiologic cause such as repetitive brain trauma (Sarff and Gold, 2010, p. S495). Therefore, alcohol withdrawal seizures should remain a diagnosis of exclusion.
Phenomenology and Course of Alcoholic Hallucinosis
Published in Journal of Dual Diagnosis, 2019
Venkata Lakshmi Narasimha, Rahul Patley, Lekhansh Shukla, Vivek Benegal, Arun Kandasamy
First, two-thirds of the patients had past episodes of alcoholic hallucinosis which highlights the recurrent nature of this illness. Although it is possible that this is an inflated estimate due to the nature of our sample, this is in agreement with an earlier study from India showing a significant risk of recurrence (Perme, Vijaysagar, & Chandrasekharan, 2003). Therefore, it is prudent to expect hallucinations in a patient who has had them in the past and thus such cases may not be suitable for community detoxification.