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酒精戒断综合征的诊断与治疗:聚焦震颤谵妄和戒断性癫痫发作

[Diagnostics and therapy of alcohol withdrawal syndrome: focus on delirium tremens and withdrawal seizure].

作者信息

Lutz Ulrich C, Batra Anil

机构信息

Universitätsklinik für Psychiatrie und Psychotherapie, Sektion für Suchtmedizin und Suchtforschung, Tübingen, Germany.

出版信息

Psychiatr Prax. 2010 Sep;37(6):271-8. doi: 10.1055/s-0030-1248443. Epub 2010 Aug 27.

Abstract

INTRODUCTION

Delirium tremens and withdrawal seizures are serious complications of an alcohol withdrawal syndrome. This review presents the diagnostic procedures required in case of the occurrence of a withdrawal seizure and delirium tremens as well as possible treatment options including prophylactic medication regimen for alcohol withdrawal syndrome. Furthermore non-pharmacological procedures accompanying delirium tremens and a potential integration of viewing videotapes of delirium tremens in the course of alcohol-specific therapy are discussed.

METHODS

A systematic literature research using Pubmed has been carried out to find recent studies and review articles dealing with alcohol withdrawal syndrome.

RESULTS AND DISCUSSION

Regarding the diagnostic algorithm in case of the occurrence of a withdrawal seizure or a delirium tremens basic diagnostic procedures and special diagnostics including neuro-imaging or cerebrospinal fluid puncture depending on patients' clinical condition have to be considered. Sedatives are important in treatment of alcohol withdrawal seizures and delirium tremens as well as in the prophylaxis of alcohol withdrawal syndrome. A long-lasting prescription of anticonvulsant medication in patients suffering from withdrawal seizure should be considered critically and can be carried out only under certain conditions.

摘要

引言

震颤谵妄和戒断性癫痫发作是酒精戒断综合征的严重并发症。本综述介绍了出现戒断性癫痫发作和震颤谵妄时所需的诊断程序,以及可能的治疗选择,包括酒精戒断综合征的预防性药物治疗方案。此外,还讨论了伴随震颤谵妄的非药物治疗程序,以及在酒精特定治疗过程中观看震颤谵妄录像带的潜在整合。

方法

利用PubMed进行了系统的文献研究,以查找有关酒精戒断综合征的最新研究和综述文章。

结果与讨论

对于出现戒断性癫痫发作或震颤谵妄的诊断算法,必须考虑基本诊断程序和特殊诊断,包括根据患者临床状况进行的神经影像学检查或脑脊液穿刺。镇静剂在治疗酒精戒断性癫痫发作和震颤谵妄以及预防酒精戒断综合征方面很重要。对于患有戒断性癫痫发作的患者,长期开具抗惊厥药物应谨慎考虑,且仅在特定条件下才可进行。

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