ГоловнаArchive of numbers2024Volume 32, issue 2 (119)Genesis and clinical significance of the symptom of strabismus in the acute period of delirium tremens
Title of the article Genesis and clinical significance of the symptom of strabismus in the acute period of delirium tremens
Authors Linskiy Igor
Kuzminov Valerii
Zadorozhnyi Volodymyr
Shulga Olena
In the section DIAGNOSTICS AND THERAPY OF MENTAL AND BEHAVIORAL DISORDERS
Year 2024 Issue Volume 32, issue 2 (119) Pages 47-52
Type of article Scientific article Index UDK 616.853-008.441.13-06 Index BBK -
Abstract DOI: https://doi.org/10.36927/2079-0325-V32-is2-2024-8

 The purpose of the work was to find out the patterns of the appearance of the strabismus symptom, to determine its pathogenetic moments and to establish its significance for the clinical manifestations of delirium tremens (DT). 647 men aged 22 to 70 were treated. 83 patients were diagnosed with alcohol withdrawal with somatic-vegetative disorders (diagnosis code according to ICD-10 F10.3). The clinical manifestations of 205 patients corresponded to the manifestations of “classic” DT (F10.4). In 359 people, clinical symptoms were interpreted as different variants of severe DT (F10.43). 2 observation groups were formed. Group 1: patients with DT, who developed strabismus during the acute period of the disease (65 people). Strabismus with abnormal position and movements of the eyeballs in the horizontal plane (convergent or divergent strabismus) was mostly observed. Group 2: patients with DT, in whom the symptom of strabismus was not observed (582 people). The DRS R-98 — Delirium Rating Scale — Revised — 98 scale and its subscales were used to characterize the clinical manifestations of DT. Scales for assessing the duration of the period of mental disorders, the expressiveness of nystagmus, the size of the pupils of the eyeballs, anisocoria, convulsive manifestations, the state of muscle tone, and the expressiveness of the manifestations of alcoholic polyneuropathy were also used. The frequency of occurrence of somatic complications and the survival rate of patients were evaluated. It was established that the appearance of strabismus in the neurological status of patients with DT does not significantly worsen the clinical course of the disease and reduce survival. This is possible when there is no damage to the nuclei and supranuclear formations of the group of oculomotor nerves in the brain stem and hemispheres, and the violation of the physiological functions of these nerves occurs due to peripheral mechanisms. There are reasons to believe that eyeball muscle damage in people with DT is the cause of oculomotor disorders and the manifestation of strabismus. In this case, the symptom of strabismus in patients with DT is not accompanied by the formation of an additional focus in the brain and does not reflect the conditions for the transformation of the disease into acute alcoholic encephalopathy. The appearance of strabismus correlates with a significant increase in the risk of developing hospital-acquired pneumonia in the acute period of DT.
Key words delirium tremens, acute development of the symptom of strabismus, correlations of strabismus with psychopathological and somatic manifestations of delirium tremens
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