It can be heralded by a variety of signs and symptoms. Some patients exhibit only mild tremulousness, irritability, difficulty in sleeping, an elevated pulse rate and hypertension, and increased temperature. Others have generalized convulsions as the first sign of difficulty. Most persons exhibit severe memory disturbance, agitation, anorexia, and hallucinations. Hallucinations are likely to follow the early signs and usually, but not always, are unpleasant and threatening to the patient.
Delusions often follow or accompany the hallucinations.
These patients are unable to think clearly and sometimes become paranoid and greatly agitated. At this point they can become dangerous to themselves and others. Generalized grand mal seizures can occur in delirium tremens. The hallucinations and delusions may continue, contributing to the state of agitation and precipitating seizures. They should be kept in a quiet, nonstimulating environment and approached in a calm, reassuring manner.