Zusammenfassung
Einleitung Die schwerwiegendsten Komplikationen des Alkoholentzugssyndroms sind der Entzugskrampfanfall
und das Delirium tremens. Die Übersichtsarbeit stellt das notwendige diagnostische,
therapeutische und prophylaktische Vorgehen sowie nichtpharmakologische Therapiemaßnahmen
beim Delirium tremens und eine mögliche Integration von Videoaufnahmen des Delirium
tremens im Rahmen der Motivationsbehandlung dar. Methodik Systematische Literaturrecherche mithilfe der Datenbank Pubmed. Ergebnisse und Diskussion Beim Auftreten eines Entzugskrampfanfalls bzw. eines Delirium tremens muss zwischen
einer Basisdiagnostik und einer weiterführenden, zustandsabhängigen Diagnostik (Bildgebung,
Liquorpunktion) unterschieden werden. In der Behandlung und Prophylaxe des Entzugssyndroms
haben Sedativa einen hohen Stellenwert. Eine dauerhafte antikonvulsive Medikation
nach einem Entzugskrampfanfall ist äußerst kritisch zu prüfen.
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.
Schlüsselwörter
Alkoholentzug - Delirium tremens - Krampfanfall - Therapie - Diagnostik
Keywords
alcohol withdrawal - delirium tremens - seizure - therapy - diagnostics
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Dr. med. Ulrich C. Lutz
Universitätsklinik für Psychiatrie und Psychotherapie
Osianderstraße 24
72076 Tübingen
Email: Ulrich.Lutz@med.uni-tuebingen.de
