Question

A 50 year old male suddenly stopped alcohol consumption for 3 days in hospital with agitation, altered sensorium, paranoid delusions and hallucinations. The most likely diagnosis is

• A. Wernicke's Encephalopathy
• B. Korsakoff's psychosis
• C. Hangover
• D. Delirium Tremens

Answer 1

The Correct Option is D

This question involves understanding the possibilities associated with sudden alcohol withdrawal symptoms. The case describes a 50-year-old male who ceased alcohol consumption abruptly for 3 days, presenting with symptoms like agitation, altered sensorium, paranoid delusions, and hallucinations. These are classic manifestations to evaluate.

Here's a breakdown of the options:

1. Wernicke's Encephalopathy: A result of thiamine (vitamin B1) deficiency, it's primarily associated with confusion, ophthalmoplegia, and ataxia, not paranoia or hallucinations.
2. Korsakoff's psychosis: Generally follows Wernicke's, leading to memory disturbances and confabulation, lacking acute agitation and hallucinations.
3. Hangover: Involves headache, nausea, and fatigue after alcohol consumption, not associated with serious psychiatric symptoms like hallucinations.
4. Delirium Tremens: Occurs 48-72 hours after cessation in chronic users. Symptoms include severe agitation, confusion, hallucinations, and autonomic instability.

Based on the timing and severe neuropsychiatric symptoms, the most likely diagnosis is Delirium Tremens.