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Alkoholentzugsdelir und akute Komplikationen

Diagnose und Behandlung

Alcohol withdrawal syndrome and acute complications

Diagnosis and treatment

  • Leitthema
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Zusammenfassung

Hintergrund

In der Notfallmedizin stellt das Alkoholentzugsdelir ein häufiges Krankheitsbild dar. Basis für die Erkennung bleibt eine genaue und vorurteilsfreie Anamnese und Befunderhebung.

Ergebnisse und Schlussfolgerung

Die Therapie erfolgt symptomadaptiert. Grundlage bleibt die Therapie mit GABAergen Substanzen wie Benzodiazepinen und Clomethiazol sowie die Gabe von Vitamin B 1 . Durch eine frühzeitige Behandlung und Erkennung der Komplikationen wie Entzugsanfällen, intrakraniellen Blutungen, Elektrolytstörungen, der Wernicke-Enzephalopathie und kardialen Rhythmusstörungen kann die Prognose deutlich verbessert werden.

Abstract

Background

Alcohol withdrawal syndrome is often seen in emergency medicine. Mandatory for diagnosis is the accurate and unprejudiced anamnesis.

Results and conclusion

Treatment should be based on symptoms. Fundamental for treatment is administration of GABA receptor-stimulating substances like benzodiazepines and clomethiazol, as well as vitamin B1. Early identification and treatment of complications (e.g., seizures, intracranial hemorrhage, electrolyte disturbance, Wernicke encephalopathy, and cardiac arrhythmias) improves the prognosis significantly.

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Abbreviations

CCT:

Zerebrale Computertomographie

GABA:

γ-Aminobuttersäure

CIWA-Ar:

„Revised clinical institute withdrawal assessment for alcohol scale“

DT:

Delirium tremens

PAWSS:

„Predicition of alcohol withdrawal severity scale“

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Authors and Affiliations

  1. Interdisziplinäres Notfallzentrum, Klinik für Neurologie und Klinische Neurophysiologie, Helios Klinikum Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Deutschland

    G. Haas

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Correspondence to G. Haas.

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Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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C. Jäkel, Lübben

S. Poloczek, Berlin

R. Somasundaram, Berlin

C. Wrede, Berlin

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Haas, G. Alkoholentzugsdelir und akute Komplikationen. Notfall Rettungsmed 19, 22–27 (2016). https://doi.org/10.1007/s10049-015-0108-7

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  • DOI: https://doi.org/10.1007/s10049-015-0108-7

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