The severity of the symptoms usually depends on the length of time the patient has had a problem of alcohol abuse and the amount of alcohol that had been drunk before the abstinence that precipitated the delirium. Generally, this syndrome begins a few days after drinking has ceased and ends within 1-5 days. 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.