A 42 Yr old male with alcohol withdrawal syndrome

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      Alcohol withdrawal seizures

Age             : 42 yrs

Gender      : male

Doa.            : 26 October 2021 


C/o : patient was brought to icu after an episode of seizures


Hopi : 

  • patient was not consuming alcohol 10 yrs back. Then he started drinking alcohol with his friends occasionally 90-180 ml whisky 2-3 times in a week to relieve his pain after work 
  • He increased alcohol consumption after the death of his wife 10 yrs back gradually to about 12 units / day 
  • He started chewing tobacco 10 yrs back ( 1 pack / day). 
  • He was on and off frequently on counselling. He stops consuming alcohol after counselling for 10 days and then goes back to consuming alcohol for about a month. 
  • He has started experiencing tremors for 2-3 days  whenever he stops consuming alcohol since 8 yrs. 
  • On 12 October he was admitted to psychiatry after the relatives noticed binging of alcohol. He was on medication fora week. Then after 2 days  of stoppage of medicine he experienced seizures. 

Past history : 

H/o hospital admissions atleast 10 times for abdominal pain following binge of alcohol. 

K/C/O hypertension since 1 year 

No H/ o DM, Asthma, CAD 

No H / o surgeries in the past 

Personal history : 

Diet    -  mixed 

Apetite - reduced, 

Sleep - adequate 

Bowel / Bladder : regular

Addiction : consumes alcohol since 10 yrs 

                     Chews tobacco since 10 yrs 

General examination : 

Pt is conscious, coherent, cooperative 

Pallor : absent 

Icterus : present 

Clubbing : absent 

Cyanosis : absent 

Lymphadenopathy: absent 

Pedal edema : absent 

Vitals : 

Temperature : afebrile 

PR : 86 bpm

RR : 14 cpm 

BP : 130/72 mm of Hg 




Systemic examination : 

ABDOMEN : 

Inspection : 

Shape of abdomen    :  distended

Umbilicus                   :  inverted 

Movement.                 : present in all quadrants

No scars, sinuses, engorged veins 



Palpation : 

Temperature.           : afebrile 

Tenderness               : absent

Palpation of liver    : palpable 

Palpation of spleen : not palpable  

Fluid thrill.                : absent 

Auscultation : 

Bowel sounds.          : present 

Bruit.                           : absent 

Investigations : 

Hemogram : 


 LFT : 



RFT : 



RBS : 



CUE : 



USG :  Grade 1 fatty liver. 

Provisional diagnosis : 

Seizures following the stoppage of medication for alcohol withdrawal  , grade 1 fatty liver. 

Treatment : 

For alcohol dependance 


Notes : 

Patient was shifted to psychiatry ward again for continuation of treatment. 











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