Alcohol withdrawal classification

Resident Survival Guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

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Overview

Stages of Alcohol Withdrawal Syndrome (AWS) may be classified as uncomplicated withdrawal (first 6 hours), alcohol hallucinosis  (8-12 hours), alcohol withdrawal seizures (12-24 hours), and alcohol withdrawal delirium (24-72 hours).

Classification

Stages of Alcohol Withdrawal Syndrome (AWS) may be classified as:

Stages of Alcohol Withdrawal Syndrome (AWS)	Time of Onset	Symptoms
Uncomplicated Withdrawal	First 6 hours	Anxiety Nausea, vomiting Headache Insomnia Mild tremors   Mild to moderate autonomic hyperactivity: Hypertension Hyperthermia  Tachycardia
Alcohol Hallucinosis	8-12 hours	Hallucinations: Auditory Visual Tactile Gustatory Olfactory Paranoia Other delusions
Alcohol Withdrawal Seizures	12-24 hours	Generalized tonic-clonic seizures   Multiple seizures (in clusters)   Status epilepticus  (3%)
Alcohol Withdrawal Delirium	24-72 hours	Confusion Alteration in consciousness   Severe autonomic changes Persistent hallucinations