Which of the following might a person suffering from alcohol withdrawal delirium experience?
options:
a) Amnesia
b) Metabolic tolerance
c) Pharmacodynamic tolerance
d) Visual hallucinations
The correct answer and explanation is:
Correct Answer: d) Visual hallucinations
Explanation (300 words):
Alcohol withdrawal delirium, also known as delirium tremens (DTs), is a severe and potentially life-threatening condition that can occur when a person who has been heavily drinking for a long period suddenly stops or significantly reduces alcohol consumption. It is most common in individuals with alcohol dependence and typically appears 48 to 72 hours after the last drink, although it can be delayed up to a week.
One of the hallmark symptoms of alcohol withdrawal delirium is visual hallucinations. These hallucinations are often vivid and disturbing, involving seeing things that aren’t there, such as insects crawling on the skin or people in the room. This symptom reflects the serious disruption of the central nervous system caused by the sudden absence of alcohol, which the brain had adapted to over time.
Chronic alcohol use enhances the effects of GABA (an inhibitory neurotransmitter) and suppresses glutamate (an excitatory neurotransmitter). When alcohol is removed abruptly, the balance tips drastically in favor of glutamate, leading to excessive neural activity. This overactivity manifests as tremors, agitation, seizures, confusion, and hallucinations.
Now, let’s briefly address the other options:
- a) Amnesia: While cognitive impairment can occur during or after heavy drinking or withdrawal, amnesia is not a primary symptom of DTs. It’s more associated with alcohol-induced brain damage such as Wernicke-Korsakoff syndrome.
- b) Metabolic tolerance: This refers to how the body becomes more efficient at metabolizing alcohol, leading to decreased effects. It is related to chronic alcohol use, not withdrawal.
- c) Pharmacodynamic tolerance: This involves changes at the cellular or receptor level due to long-term alcohol use. Again, this relates to chronic exposure, not withdrawal.
In summary, visual hallucinations are a key symptom of alcohol withdrawal delirium, making option d the correct answer.