Substance abuse seizures Flashcards
What are 2 questionnaires which can use in alcohol withdrawal that can be used to assess the severity of the alcohol misuse?
- AUDIT
- SADQ
What are 7 features of a presentation fo simple alcohol withdrawal?
- Insomnia
- Anxiety
- Tremor
- Nausea and vomiting
- Sweating
- Palpitations
- Agitation
Within what time frame will the features of simple withdrawal from alcohol appear?
6-12 hours
Within what time frame following the last drink will the presentation of alcohol hallucinosis occur?
12-24 hours
What does alcohol hallucinosis involve?
hallucinations of visual, tactile or auditory origin
What are 3 findings on examination of observations in delirium tremens?
tachycardia, hypertension, hyperthermia
What are 3 key features of delirium tremens?
delusions, confusion, seizures
What are 4 aspects of the management of assisted alcohol withdrawal when indicated?
- chlordiazepoxide (or diazepam, long acting benzos): prescribed in a reducing regimen in accordance with CIWA score / local protocol
- rapid-acting benzodiazepine e.g. IV lorazepam in seizure
- Pabrinex: 1 pair of ampoules once daily
- 2 pais TDS if signs of Wernicke’s encephalopathy
- Oral lorazepam first line if DT
What determines the dosing of chlordiazepoxide in assisted alcohol withdrawal? 2 things
- CIWA score (mapped on a chart)
- Local protocol
What number of units per day is an indication for assisted alcohol withdrawal?
over 15 units per day
What AUDIT questionnaire score is an indication for assisted alcohol withdrawal?
20 or more
What are 4 signs of Wernicke’s encephalopathy?
- Confusion
- Ataxia
- Ophthalmoplegia
- Nystagmus
What is the dosing of Pabrinex in assisted alcohol withdrawal?
1 pair of ampoules OD, or if signs of Wernicke’s, 2 pairs of ampoules TDS
What type seizures are caused by alcohol withdrawal?
generalised convulsions - tonic clonic
