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Emergency: requires immediate attention
Alcohol withdrawal syndrome
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Emergency: requires immediate attention

Alcohol withdrawal syndrome

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Contributors: Andrea Wasilewski MD, Benjamin L. Mazer MD, MBA, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

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Synopsis

Early Signs
Alcohol is a nervous system depressant, depressing alpha- and beta-adrenergic receptors and enhancing GABA receptors in the brain. Therefore, alcohol withdrawal in a dependent person may cause depression of the GABA inhibitory pathway in the brain. This leads to excitation of the nervous system that manifests as tremors, tachycardia, diaphoresis, and restlessness. Symptoms of withdrawal can begin within 6 hours of drinking cessation. Alcohol withdrawal seizures are generalized convulsions that most often occur within 12-48 hours after alcohol cessation.

Severe withdrawal may cause seizures and electrolyte disturbances. Delirium tremens (DT) is another severe manifestation of alcohol withdrawal and may occur 3-10 days after cessation. DT manifests as confusion, hallucination, and autonomic dysfunction.

Severe alcohol withdrawal is a life-threatening condition. Alcohol withdrawal is treated with benzodiazepines, which enhance GABA activity. Thiamine supplementation is also provided to prevent the development of Wernicke-Korsakoff syndrome. The Clinical Institute Withdrawal Assessment for Alcohol (CIWA) is an often-used tool to assess the extent of withdrawal and direct therapy.

Codes

ICD10CM:
F10.239 – Alcohol dependence with withdrawal, unspecified

SNOMEDCT:
191480000 – Alcohol Withdrawal Syndrome

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Last Reviewed: 01/03/2019
Last Updated: 01/03/2019
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Emergency: requires immediate attention
Alcohol withdrawal syndrome
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Alcohol withdrawal syndrome (Early Signs) : Headache, Nausea/vomiting, Anxiety, Insomnia, Heart palpitations, Anorexia, Tremor, Hallucination, 6-8 hours after withdrawal

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